FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Gariti, P Alterman, AI Mulvaney, FD Epperson, L AF Gariti, P Alterman, AI Mulvaney, FD Epperson, L TI The relationship between psychopathology and smoking cessation treatment response SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE smokers; psychiatric diagnosis; patch treatment; mental disorder; DSM-IV ID NICOTINE PATCH; MAJOR DEPRESSION; CIGARETTE-SMOKING; DRUG PROBLEMS; SMOKERS; ALCOHOL; RELIABILITY; DISORDER; HISTORY; TOBACCO AB The study evaluated the relationship of psychopathology to treatment response of 208 smokers prescribed transdermal nicotine (8 weeks). Participants were relatively high functioning (DSM-IV axis V score) outpatients in a university-based clinic. The primary study objective was to determine whether patients with a history of either a DSM-IV axis I or II diagnosis would have poorer during treatment response (patch adherence, smoking) and lower rates of smoking cessation at post-patch follow-up (study weeks 9, 26, 52) than those without a diagnosis. While there was some indication that patients with a history of psychopathology wore the patch less Frequently, psychopathology was not associated with during- and post-treatment smoking. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved. C1 Univ Penn, Sch Med, Treatment Res Ctr, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Gariti, P (reprint author), Univ Penn, Sch Med, Treatment Res Ctr, Dept Psychiat, 3900 Chesternut St, Philadelphia, PA 19104 USA. FU NIDA NIH HHS [DA10070] NR 38 TC 14 Z9 14 U1 1 U2 1 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0376-8716 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD NOV 1 PY 2000 VL 60 IS 3 BP 267 EP 273 DI 10.1016/S0376-8716(00)00114-9 PG 7 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 368AV UT WOS:000090096100006 PM 11053761 ER PT J AU Ito, T Tajima, F Ogawa, M AF Ito, T Tajima, F Ogawa, M TI Developmental changes of CD34 expression by murine hematopoietic stem cells SO EXPERIMENTAL HEMATOLOGY LA English DT Article DE stem cells; CD31; development; hematopoiesis ID CORD-BLOOD TRANSPLANTATION; MARROW-CELLS AB Objective. It has been reported that fetal murine hematopoietic stem cells are CD34(+), whereas adult stem cells are CD34(-). We sought to delineate the developmental changes of CD34 expression by hematopoietic stem cells and carried out systematic analysis of long-term engrafting cells in the bone marrow and/or blood of perinatal, juvenile, and adult mice. Materials and Methods. To obtain information on the total population of stem cells, we prepared CD34(+) and CD34(-) populations of mononuclear cells without prior enrichment and assayed their long-term reconstituting abilities by transplantation into lethally irradiated Ly-5 congenic mice. Results, All stem cells from perinatal to 5-week-old mice were CD34(+). In 7-week-old mice, CD3(4)- stem cells began to emerge, and the majority of the stem cells mere CD34(-) in the 10- and IO-week-old mice, Approximately 20% of adult stem cells expressed CD34. Conclusions. Developmental changes of CD34 expression from the positive to the negative state takes place between 7 and 10 weeks of age for the majority of murine stem cells. Approximately 20% of adult stem cells remain CD34(+). These observations provide insight into the current controversy regarding CD34 expression by adult hematopoietic stem cells and suggest that the majority of stem cells in human umbilical cord blood and bone marrow of young children are CD34(+). (C) 2000 International Society for Experimental Hematology. Published by Elsevier Science Inc. C1 Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Dept Vet Affairs Med Ctr, Charleston, SC USA. RP Ogawa, M (reprint author), Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. FU NCI NIH HHS [P01-CA78582]; NIDDK NIH HHS [R01-DK54197] NR 14 TC 73 Z9 76 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0301-472X J9 EXP HEMATOL JI Exp. Hematol. PD NOV PY 2000 VL 28 IS 11 BP 1269 EP 1273 DI 10.1016/S0301-472X(00)00535-X PG 5 WC Hematology; Medicine, Research & Experimental SC Hematology; Research & Experimental Medicine GA 374RQ UT WOS:000165358500009 PM 11063875 ER PT J AU Ganzini, L Cohen, LM AF Ganzini, L Cohen, LM TI Resolution and ambivalence - Commentary SO HASTINGS CENTER REPORT LA English DT Editorial Material C1 Portland Vet Affairs Med Ctr, Portland, OR 97207 USA. Bay State Med Ctr, Psychiat Consultat Serv, Springfield, MA USA. RP Ganzini, L (reprint author), Portland Vet Affairs Med Ctr, Portland, OR 97207 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU HASTINGS CENTER PI BRIARCLIFF MANOR PA 255 ELM ROAD, BRIARCLIFF MANOR, NY 10510 USA SN 0093-0334 J9 HASTINGS CENT REP JI Hastings Cent. Rep. PD NOV-DEC PY 2000 VL 30 IS 6 BP 25 EP 25 PG 1 WC Ethics; Health Care Sciences & Services; Medical Ethics; Social Sciences, Biomedical SC Social Sciences - Other Topics; Health Care Sciences & Services; Medical Ethics; Biomedical Social Sciences GA 386FW UT WOS:000166051000011 ER PT J AU Nicholson, S Pauly, MV Burns, LR Baumritter, A Asch, DA AF Nicholson, S Pauly, MV Burns, LR Baumritter, A Asch, DA TI Measuring community benefits provided by for-profit and nonprofit hospitals SO HEALTH AFFAIRS LA English DT Article AB Nonprofit hospitals are expected to provide benefits to their community in return for being exempt from most taxes. In this paper we develop a new method of identifying activities that should qualify as community benefits and of determining a benchmark for the amount of community benefits a nonprofit hospital should be expected to provide. We then compare estimates of nonprofits' current level of community benefits with our benchmark and show that actual provision appears to fall short. Either nonprofit hospitals as a group ought to provide more community benefits. or they are performing activities that cannot be measured. In either case, better measurement and accounting of community benefits would improve public policy. C1 Univ Penn, Wharton Sch, Hlth Care Syst Dept, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Nicholson, S (reprint author), Univ Penn, Wharton Sch, Hlth Care Syst Dept, Philadelphia, PA 19104 USA. NR 10 TC 32 Z9 32 U1 2 U2 4 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD NOV-DEC PY 2000 VL 19 IS 6 BP 168 EP 177 DI 10.1377/hlthaff.19.6.168 PG 10 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 373PH UT WOS:000165297500019 PM 11192400 ER PT J AU Mathurin, P Deng, QG Keshavarzian, A Choudhary, S Holmes, EW Tsukamoto, H AF Mathurin, P Deng, QG Keshavarzian, A Choudhary, S Holmes, EW Tsukamoto, H TI Exacerbation of alcoholic liver injury by enteral endotoxin in rats SO HEPATOLOGY LA English DT Article ID TUMOR-NECROSIS-FACTOR; INTERCELLULAR-ADHESION MOLECULE-1; LIPOPOLYSACCHARIDE-BINDING-PROTEIN; CYTOKINE GENE-EXPRESSION; KUPFFER CELLS; INTESTINAL PERMEABILITY; DISEASE; ETHANOL; CIRRHOSIS; HEPATITIS AB Increased gut permeability (leaky gut) and endotoxin-mediated Kupffer cell activation are proposed as the mechanisms of alcoholic liver injury. Although ethanol feeding is shown to sensitize the liver for injury induced by parental administration of lipopolysaccharide (LPS), how enteral LPS loading affects alcoholic liver injury is yet to be tested. The present study provides direct evidence for enhanced entrance to portal circulation of LPS enterally administered to the intragastric ethanol infusion model. Portal and systemic blood endotoxin levels increased to 43.0 +/- 4.1 and 6.2 +/- 4.3 pg/mL at 2 hours following enteral LPS administration (5 mg/kg) in alcohol-fed animals, while no such increases were observed in pair-fed controls. However, endotoxin levels in systemic blood of alcohol-fed rats were reduced to 0 to 1.5 pg/mL 16 hours after LPS administration. Weekly enteral administration of LPS to the model for 9 weeks exacerbated an increase in plasma alanine transaminase (ALT) levels (227 +/- 75 vs. 140 +/- 70; P <.01), mononuclear infiltration (25 +/- 22 vs. 6.4 +/- 4.4/10 mm(2); P=.02), sinusoidal congestion, and spotty necrosis, and induced diffuse coagulative necrosis and centrilobular fibrosis in some animals. Reverse-transcription polymerase chain reaction (RT-PCR) analysis confirmed the LPS effect at the tissue level by demonstrating accentuated induction of tumor necrosis factor (TNF-alpha) and Cox-2 mRNA, In conclusion, enteral LPS administration potentiates alcoholic liver necrosis, inflammation, and fibrosis despite efficient endotoxin clearance by the liver and mild systemic endotoxemia that occurs episodically following enteral LPS challenge. C1 Univ So Calif, Keck Sch Med, Dept Med, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Dept Pathol, Los Angeles, CA 90033 USA. Greater Los Angeles VA Hlth Care Syst, Sepulveda, CA USA. Rush Presbyterian St Lukes Med Ctr, Div Digest Dis, Chicago, IL 60612 USA. Loyola Univ, Stritch Sch Med, Dept Pathol, Chicago, IL 60611 USA. RP Tsukamoto, H (reprint author), Univ So Calif, Keck Sch Med, Dept Med, 1333 San Pablo St,MMR-414, Los Angeles, CA 90033 USA. FU NIAAA NIH HHS [P50-AA11999, R37-AA06603] NR 45 TC 166 Z9 179 U1 3 U2 7 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD NOV PY 2000 VL 32 IS 5 BP 1008 EP 1017 DI 10.1053/jhep.2000.19621 PG 10 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 367KV UT WOS:000090061000017 PM 11050051 ER PT J AU Ehsan, A Fan, HX Eagan, PA Siddiqui, HA Gulley, ML AF Ehsan, A Fan, HX Eagan, PA Siddiqui, HA Gulley, ML TI Accumulation of p53 in infectious mononucleosis tissues SO HUMAN PATHOLOGY LA English DT Article DE Epstein-Barr virus; infectious mononucleosis; EBER1; p53; BZLF1; LMP1 ID EPSTEIN-BARR-VIRUS; BURKITTS-LYMPHOMA CELL; NON-HODGKINS-LYMPHOMAS; TUMOR-SUPPRESSOR GENE; REED-STERNBERG CELLS; PROTEIN EXPRESSION; CARRIER STATE; B-CELLS; REPLICATION; DISEASE AB Epstein-Barr virus (EBV) infects lymphocytes, where it persists indefinitely for the life of the host; whether the virus interacts with p53 to maintain itself in these cells is unknown. Lymphoid biopsy samples from 10 patients with infectious mononucleosis (IM) were examined for expression of p53 by immunohistochemistry. Accumulation of p53 was detected in all 10 cases, primarily in large lymphocytes of the expanded paracortex. The presence of EBV was con firmed in all 10 cases by EBER1 (EBV-encoded RNA) in situ hybridization, whereas 11 non-IM control samples lacked significant EBER1 and did not express p53 in paracortical lymphocytes. Interestingly, EBV infection alone does not cause accumulation of intracellular p53, because many more cells expressed EBER1 than p53 in the IM tissues. To determine whether p53 was confined to the subset of infected cells in which viral replication was occurring, BZLF1 immunostains were performed. Viral BZLF1 was detected in 8 of 10 IM tissues; however, the paucity and small size of the BZLF1-expressing lymphocytes suggests that they are not the same cells overexpressing p53. To further examine the relationship between p53 and EBV gene expression, the tissues were studied for latent membrane protein 1 (LMP1) expression by immunohistochemistry. Viral LMP1 was observed in the large paracortical lymphocytes of all 10 cases of IM, indicating co-localization of p53 and LMP1 in these cells. Our findings confirm that p53 overexpression is not specific for nodal malignancy and that p53 accumulation is characteristic of IM. Because p53 was not coexpressed in the same cells as BZLF1, it appears that BZLF1 is not directly responsible for p53 accumulation. Nevertheless, co-localization of p53 and LMP1 in activated-appearing lymphocytes suggests that EBV infection is responsible for p53 accumulation. HUM PATHOL 31:1397-1403. Copyright (C) 2000 by W.B. Saunders Company. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Hosp, San Antonio, TX 78284 USA. RP Ehsan, A (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, MSC 7750,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 38 TC 9 Z9 10 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0046-8177 J9 HUM PATHOL JI Hum. Pathol. PD NOV PY 2000 VL 31 IS 11 BP 1397 EP 1403 DI 10.1053/hupa.2000.19447 PG 7 WC Pathology SC Pathology GA 376JJ UT WOS:000165454200010 PM 11112215 ER PT J AU Parada, JP Shapiro, DS AF Parada, JP Shapiro, DS TI Salmonella abscess of the ovary SO INFECTIONS IN MEDICINE LA English DT Article DE ovarian cyst; Salmonella; abscess; zoonosis AB A 21-year-old vegetarian with a household exposure to a pet turtle and a history of an ovarian cyst presented with an ovarian abscess caused by Salmonella hartford. This case highlights the facts that Salmonella species are associated with reptilian zoonotic transmission and have a predilection for localization in a site of preexisting abnormality. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. RP Parada, JP (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. NR 4 TC 0 Z9 0 U1 1 U2 1 PU SCP COMMUNICATIONS INC PI NEW YORK PA 134 W 29TH ST, NEW YORK, NY 10001-5304 USA SN 0749-6524 J9 INFECT MED JI Infect. Med. PD NOV PY 2000 VL 17 IS 11 BP 761 EP 762 PG 2 WC Infectious Diseases SC Infectious Diseases GA 373GJ UT WOS:000165280200015 ER PT J AU Bohning, DE Shastri, A McGavin, L McConnell, KA Nahas, Z Lorberbaum, JP Roberts, DR George, MS AF Bohning, DE Shastri, A McGavin, L McConnell, KA Nahas, Z Lorberbaum, JP Roberts, DR George, MS TI Motor cortex brain activity induced by 1-Hz transcranial magnetic stimulation is similar in location and level to that for volitional movement SO INVESTIGATIVE RADIOLOGY LA English DT Article DE transcranial magnetic stimulation, functional MR imaging, human; motor cortex, volitional movement, blood flow, imaging ID HUMAN CEREBRAL-CORTEX; ACTIVATION; CONNECTIVITY; EXCITATION; FMRI; TOOL; TMS; PET AB RATIONALE AND OBJECTIVES. The relatively high temporal and spatial resolution of functional MR imaging was used to compare the blood oxygenation level dependent (BOLD) response associated with movement induced by transcranial magnetic stimulation (TMS) with that for a similar movement executed volitionally (VOL). METHODS. Seven healthy adults were studied in a 1.5-T MR scanner. One hertz TMS at 110% of motor threshold was applied over the motor cortex for the thumb in 21-pulse trains in alternation,vith VOL every 63 seconds and interleaved with functional MR imaging. RESULTS. BOLD increases in motor cortex associated with TMS and VOL movement were similar (2%-3%). Mean separation of their centers of activity was 3.7 +/- 1.9 mm (mean displacement: left/right = 0.3 +/- 4.1 mm; superior/inferior = 0.7 +/- 1.9 mm), There was no indication of supraphysiological brain activity, CONCLUSIONS. Motor cortex BOLD response associated with thumb movement induced by 1-Hz TMS at 110% motor threshold is similar in both location and level to that caused by a similar movement executed volitionally. C1 Med Univ S Carolina, Dept Radiol, Funct Neuroimaging Res Div, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Psychiat, Funct Neuroimaging Res Div, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurol, Funct Neuroimaging Res Div, Charleston, SC 29425 USA. Ralph H Johnson Vet Hosp, Charleston, SC USA. RP Bohning, DE (reprint author), Med Univ S Carolina, Dept Radiol, Funct Neuroimaging Res Div, 171 Ashley Ave, Charleston, SC 29425 USA. NR 19 TC 55 Z9 56 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0020-9996 J9 INVEST RADIOL JI Invest. Radiol. PD NOV PY 2000 VL 35 IS 11 BP 676 EP 683 DI 10.1097/00004424-200011000-00005 PG 8 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 374CF UT WOS:000165326300005 PM 11110304 ER PT J AU Steinman, MA AF Steinman, MA TI Gifts to physicians in the consumer marketing era SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Review ID PHARMACEUTICAL SALES REPRESENTATIVES; ATTITUDES; RESIDENTS; BEHAVIOR; INDUSTRY; FACULTY C1 San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Steinman, MA (reprint author), San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. NR 15 TC 8 Z9 9 U1 1 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD NOV 1 PY 2000 VL 284 IS 17 BP 2243 EP 2243 DI 10.1001/jama.284.17.2243 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 367GD UT WOS:000090052600038 PM 11056602 ER PT J AU Tsou, R Cole, JK Nathens, AB Isik, FF Heimbach, DM Engrav, LH Gibran, NS AF Tsou, R Cole, JK Nathens, AB Isik, FF Heimbach, DM Engrav, LH Gibran, NS TI Analysis of hypertrophic and normal scar gene expression with cDNA microarrays SO JOURNAL OF BURN CARE & REHABILITATION LA English DT Article; Proceedings Paper CT 32nd Annual Meeting of the American-Burn-Association CY MAR 14-17, 2000 CL LAS VEGAS, NEVADA SP Amer Burn Assoc ID GROWTH-FACTOR-I; MESSENGER-RNAS; TISSUE; LOCALIZATION; IDENTIFICATION; COLLAGENASE; DISCOVERY; ARRAYS; TIMP AB Hypertrophic scar is one form of abnormal wound healing. Previous studies have suggested that hypertrophic scar formation results from altered gene expression of extracellular matrix molecules. A broadscale evaluation of gene expression in hypertrophic scars has not been reported. To better understand abnormalities in hypertrophic scar gene expression, we compared messenger RNA expression in hypertrophic scars, normal scars, and uninjured skin with the use of complementary (c)DNA microarrays. Total RNA was extracted from freshly excised human hypertrophic scars, normal scars, or uninjured skin and reverse transcribed into cDNA with the incorporation of [P-33] deoxycytidine triphosphate. The resulting radioactive cDNA probes were hybridized onto cDNA microarrays of 4000 genes. Hybridization signals were normalized and analyzed. In the comparison of tissue samples, mean intensities were calculated for each gene within each group (hypertrophic scars, normal scars, and uninjured skin). Ratios of the mean intensities of hypertrophic scars to normal scars, hypertrophic scars to uninjured skin, and normal scars to uninjured skin were generated. A ratio that was greater than 1 indicated upregulation of any particular gene and a ratio that was less than 1 indicated downregulation of any particular gene. Our data indicated that 142 genes were overexpressed and 50 genes were underexpressed in normal scars compared with uninjured skin, 107 genes were overexpressed and 71 were underexpressed in hypertrophic scars compared with uninjured skin, and 44 genes were overexpressed and 124 were underexpressed in hypertrophic scars compared with normal scars. Our analysis of collagen, growth factor, and metalloproteinase gene expression confirmed that our molecular data were consistent with published biochemical and clinical observations of normal scars and hypertrophic scars. cDNA microarray analysis provides a powerful tool for the investigation of differential gene expression in hypertrophic scar samples and either uninjured skin or normal scars. Our data validate the use of this technology for future studies on gene expression during repair processes of normal and abnormal wounds. C1 Univ Washington, Harborview Med Ctr, Burn Ctr, Seattle, WA 98104 USA. VA Puget Sound Hlth Care Syst, Harborview Med Ctr, Dept Surg, Seattle, WA USA. RP Gibran, NS (reprint author), Univ Washington, Harborview Med Ctr, Burn Ctr, 325 9Th Ave,Box 359796, Seattle, WA 98104 USA. NR 26 TC 39 Z9 46 U1 1 U2 4 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0273-8481 J9 J BURN CARE REHABIL JI J. Burn Care Rehabil. PD NOV-DEC PY 2000 VL 21 IS 6 BP 541 EP 550 DI 10.1067/mbc.2000.110808 PG 10 WC Emergency Medicine; Rehabilitation; Surgery SC Emergency Medicine; Rehabilitation; Surgery GA 390EE UT WOS:000166282100012 PM 11194809 ER PT J AU Dresselhaus, TR Peabody, JW Lee, M Wang, MM Luck, J AF Dresselhaus, TR Peabody, JW Lee, M Wang, MM Luck, J TI Measuring compliance with preventive care guidelines - Standardized patients, clinical vignettes, and the medical record SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE compliance; preventive cars guidelines; physician practice ID SIMULATED PATIENTS; HEALTH-CARE; PERFORMANCE; QUALITY; RECOMMENDATIONS; INTERNISTS; ADULT AB OBJECTIVE: To determine how accurately preventive cars reported in the medical record reflects actual physician practice or competence. DESIGN:Scoring criteria based on national guidelines were developed for 7 separate items of preventive care. The preventive care provided by randomly selected physicians was measured prospectively for each of the 7 items. Three measurement methods were used for comparison: (1) the abstracted medical record from a standardized patient (SP) visit: (2) explicit reports of physician practice during those visits from the SPs, who were actors trained to present undetected as patients: and (3) physician responses to written case scenarios (vignettes) identical to the SP presentations. SETTING: The general medicine primary care clinics of two university-affiliate VA medical centers. PARTICIPANTS: Twenty randomly selected physicians (10 at each site) from among eligible second- and third-year general internal medicine residents and attending physicians. MEASUREMENTS AND MAIN RESULTS: Physicians saw 160 SPs (8 cases x 20 physicians). Ws calculated the percentage of visits in which each prevention item was recorded in the chart, determined the marginal percentage improvement of SP checklists and vignettes over chart abstraction alone, and compared the three methods using an analysis-of-variance model. Ws found that chart abstraction underestimated overall prevention compliance by 16% (P < .01) compared with SP checklists. Chart abstraction scores were lower than SP checklists for all seven items and lower than vignettes for four items. The marginal percentage improvement of SP checklists and vignettes to performance as measured by chart abstraction was significant for all seven prevention items and raised the overall prevention scores from 46% to 72% (P < .0001). CONCLUSIONS: These data indicate that physicians perform more preventive cars than they report in the medical record. Thus, benchmarks of preventive care by individual physicians and institutions that rely solely on the medical record may be misleading, at best. C1 Inst Global Hlth, San Francisco, CA 94105 USA. Vet Affairs San Diego Healthcare Syst, San Diego, CA USA. Univ Calif San Diego, Sch Med, San Diego, CA 92103 USA. Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Med, San Francisco, CA USA. Vet Affairs Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Peabody, JW (reprint author), Inst Global Hlth, 74 New Montgomery St,Suite 508, San Francisco, CA 94105 USA. NR 28 TC 82 Z9 82 U1 1 U2 2 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD NOV PY 2000 VL 15 IS 11 BP 782 EP 788 DI 10.1046/j.1525-1497.2000.91007.x PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 375NJ UT WOS:000165406600004 PM 11119170 ER PT J AU Medh, JD Fry, GL Bowen, SL Ruben, S Wong, H Chappell, DA AF Medh, JD Fry, GL Bowen, SL Ruben, S Wong, H Chappell, DA TI Lipoprotein lipase- and hepatic triglyceride lipase-promoted very low density lipoprotein degradation proceeds via an apolipoprotein E-dependent mechanism SO JOURNAL OF LIPID RESEARCH LA English DT Article DE heparan sulfate proteoglycans; LDL receptors; fibroblasts; apoE knockout mice ID RECEPTOR-RELATED PROTEIN; HEPARAN-SULFATE PROTEOGLYCANS; CELL-SURFACE PROTEOGLYCANS; IN-VITRO; CHYLOMICRON REMNANTS; RICH LIPOPROTEINS; ENHANCED BINDING; ALPHA(2)-MACROGLOBULIN RECEPTOR; HUMAN FIBROBLASTS; TERMINAL DOMAIN AB Apolipoprotein E (apoE) is the primary recognition signal on triglyceride-rich lipoproteins responsible for interacting with low density Lipoprotein (LDL) receptors and LDL receptor-related protein (LRP). It has been shown that lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL) promote receptor-mediated uptake and degradation of very low density lipoproteins (VLDL) and remnant particles, possibly by directly binding to lipoprotein receptors. In this study we hare investigated the requirement for apoE in lipase-stimulated VLDL degradation. We compared binding and degradation of normal and apoE-depleted human VLDL and apoE knockout mouse VLDL in human foreskin fibroblasts. Surface binding at 37 degreesC of apoE knockout VLDL was greater than that of normal VLDL by 3- and 40-fold, respectively, in the presence of LPL and HTGL. In spite of the greater stimulation of surface binding, lipase-stimulated degradation of apoE knockout mouse VLDL was significantly lower than that of normal VLDL (30, 30, and 80%, respectively, for control, LPL, and HTGL treatments). In the presence of LPL and HTGL, surface binding of apoE-depleted human VLDL was, respectively, 40 and 200% of normal VLDL whereas degradation was, respectively, 25 and 50% of normal VLDL. LPL and HTGL stimulated degradation of normal VLDL in a dose-dependent manner and by a LDL receptor-mediated pathway. Maximum stimulation (4-fold) was seen in the presence LPL (1 mug/ml) or HTGL (3 mug/ml) in lovastatin-treated cells. On the other hand, degradation of apoE-depleted VLDL was not significantly increased by the presence of lipases even in lovastatin-treated cells. Surface binding of apoE-depleted VLDL to metabolically inactive cells at 4 degreesC was higher in control and HTGL-treated cells, but unchanged in the presence of LPL. Degradation of prebound apoE-depleted VLDL was only 35% as efficient as that of normal VLDL. Surface binding of apoE knockout or apoE-depleted VLDL was to heparin sulfate proteoglycans because it was completely abolished by heparinase treatment. However, apoE appears to be a primary determinant for receptor-mediated VLDL degradation. Our studies suggest that overexpression of LPL or HTGL may not protect against lipoprotein accumulation seen in apoE deficiency. C1 Univ Iowa, Coll Med, Dept Internal Med, Iowa City, IA 52242 USA. W Los Angeles Vet Affairs Med Ctr, Lipid Res Lab, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. RP Medh, JD (reprint author), Univ Iowa, Coll Med, Dept Internal Med, Iowa City, IA 52242 USA. FU NHLBI NIH HHS [P01 HL049264-09, HL49264] NR 70 TC 26 Z9 28 U1 0 U2 0 PU LIPID RESEARCH INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0022-2275 J9 J LIPID RES JI J. Lipid Res. PD NOV PY 2000 VL 41 IS 11 BP 1858 EP 1871 PG 14 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 372FC UT WOS:000165222800017 PM 11060356 ER PT J AU Daws, LC Gould, GG Teicher, SD Gerhardt, GA Frazer, S AF Daws, LC Gould, GG Teicher, SD Gerhardt, GA Frazer, S TI 5-HT1B receptor-mediated regulation of serotonin clearance in rat hippocampus in vivo SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE serotonin transporter; 5-HT1B autoreceptor; chronoamperometry; hippocampus; rat ID IN-VIVO; EXTRACELLULAR SEROTONIN; TRANSPORTER FUNCTION; DOPAMINE RELEASE; BRAIN; 5-HYDROXYTRYPTAMINE; ANTAGONISTS; MODULATE; BINDING; PHOSPHORYLATION AB The 5-hydroxytryptamine (5-HT; serotonin) transporter (5-HTT) is important in terminating serotonergic neurotransmission and is a primary target for many psychotherapeutic drugs. Study of the regulation of 5-HTT activity is therefore important in understanding the control of serotonergic neurotransmission. Using highspeed chronoamperometry, we have demonstrated that local application of 5-HT1B antagonists into the CA3 region of the hippocampus prolongs the clearance of 5-HT from extracellular fluid (ECF). In the present study, we demonstrate that the 5-HT1B antagonist cyanopindolol does not produce this effect by increasing release of endogenous 5-HT or by directly binding to the 5-HTT. Dose-response studies showed that the potency of cyanopindolol to inhibit clearance of 5-HT was equivalent to that of the selective 5-HT reuptake inhibitor fluvoxamine. Local application of the 5-HT1A antagonist WAY 100635 did not alter 5-HT clearance, suggesting that the effect of cyanopindolol to prolong clearance is not via a mechanism involving 5-HT1A receptors. Finally, the effect of low doses of cyanopindolol and fluvoxamine to inhibit clearance of 5-HT from ECF was additive. These data are consistent with the hypothesis that activation of terminal 5-HT1B autoreceptors increases 5-HTT activity. C1 Univ Texas, Hlth Sci Ctr, Dept Pharmacol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Mem Hosp Div, San Antonio, TX USA. Univ Kentucky, Dept Neurol, Lexington, KY USA. Univ Kentucky, Dept Neurobiol & Anat, Lexington, KY USA. RP Daws, LC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pharmacol, Mail Code 7764,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM daws@uthscsa.edu OI Gould, Georgianna/0000-0002-5470-8763 FU NIMH NIH HHS [MH01245, MH57001] NR 43 TC 56 Z9 56 U1 0 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD NOV PY 2000 VL 75 IS 5 BP 2113 EP 2122 DI 10.1046/j.1471-4159.2000.0752113.x PG 10 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 365AA UT WOS:000089925200036 PM 11032901 ER PT J AU Tyurin, VA Tyurina, YY Borisenko, GG Sokolova, TV Ritov, VB Quinn, PJ Rose, M Kochanek, P Graham, SH Kagan, VE AF Tyurin, VA Tyurina, YY Borisenko, GG Sokolova, TV Ritov, VB Quinn, PJ Rose, M Kochanek, P Graham, SH Kagan, VE TI Oxidative stress following traumatic brain injury in rats: Quantitation of biomarkers and detection of free radical intermediates SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE traumatic brain injury; oxidative stress; ascorbate; spin traps; thiols; 8-epi-prostaglandin F-2 alpha ID ELECTRON-SPIN-RESONANCE; LIPID-PEROXIDATION; VITAMIN-E; IN-VIVO; CEREBRAL-ISCHEMIA; PHENOXYL RADICALS; MODEL SYSTEMS; HEAD-INJURY; CYCLOOXYGENASE; ASCORBATE AB Oxidative stress may contribute to many pathophysiologic changes that occur after traumatic brain injury. In the current study, contemporary methods of detecting oxidative stress were used in a rodent model of traumatic brain injury. The level of the stable product derived from peroxidation of arachidonyl residues in phospholipids, 8-epi-prostaglandin F-2 alpha, was increased at 6 and 24 h after traumatic brain injury. Furthermore, relative amounts of fluorescent end products of lipid peroxidation in brain extracts were increased at 6 and 24 h after trauma compared with sham-operated controls. The total antioxidant reserves of brain homogenates and water-soluble antioxidant reserves as well as tissue concentrations of ascorbate, GSH, and protein sulfhydryls were reduced after traumatic brain injury. A selective inhibitor of cyclooxygenase-2, SC 58125, prevented depletion of ascorbate and thiols, the two major water-soluble antioxidants in traumatized brain. Electron paramagnetic resonance (EPR) spectroscopy of rat cortex homogenates failed to detect any radical adducts with a spin trap, 5,5-dimethyl-1-pyrroline N-oxide, but did detect ascorbate radical signals. The ascorbate radical EPR signals increased in brain homogenates derived from traumatized brain samples compared with sham-operated controls. These results along with detailed model experiments in vitro indicate that ascorbate is a major antioxidant in brain and that the EPR assay of ascorbate radicals may be used to monitor production of free radicals in brain tissue after traumatic brain injury. C1 Univ Pittsburgh, Dept Environm & Occupat Hlth, Pittsburgh, PA 15238 USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Anesthesiol & Crit Care Med, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Pharmacol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Inst Canc, Pittsburgh, PA USA. VA Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. Kings Coll London, Div Life Sci, London W8 7AH, England. Russian Acad Sci, Inst Evolutionary Physiol & Biochem, St Petersburg 196140, Russia. RP Kagan, VE (reprint author), Univ Pittsburgh, Dept Environm & Occupat Hlth, 260 Kappa Dr, Pittsburgh, PA 15238 USA. EM kagan@pitt.edu RI Kochanek, Patrick/D-2371-2015; Quinn, Peter/E-4019-2010 OI Kochanek, Patrick/0000-0002-2627-913X; Tyurin, Vladimir/0000-0002-3474-1697 FU NINDS NIH HHS [NS30318] NR 61 TC 153 Z9 156 U1 1 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD NOV PY 2000 VL 75 IS 5 BP 2178 EP 2189 DI 10.1046/j.1471-4159.2000.0752178.x PG 12 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 365AA UT WOS:000089925200043 PM 11032908 ER PT J AU Nicosia, MA Hind, JA Roecker, EB Carnes, M Doyle, J Dengel, GA Robbins, J AF Nicosia, MA Hind, JA Roecker, EB Carnes, M Doyle, J Dengel, GA Robbins, J TI Age effects on the temporal evolution of isometric and swallowing pressure SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID COMPUTED-TOMOGRAPHY; SKELETAL-MUSCLE; ELDERLY MEN; ENDURANCE; VISCOSITY; DYSPHAGIA; VOLUME; FORCE; YOUNG AB Background. The tongue plays a key role in bolus propulsion through the oropharyngeal chamber. In this study, possible age effects on the magnitude and timing of lingual pressure generation were analyzed. Methods. Oral pressure was measured during isometric and swallowing tasks for 10 elderly (mean age = 81 years) and 10 young (mean age = 51 years) subjects. Three trials each of the isometric task and swallows of three different boluses (3 mi semisolid, 3 mi liquid, and 10 mi liquid) were performed by each subject. The timing and magnitude of isometric and swallowing pressure generation along with the pattern of the swallowing pressure waveform were analyzed. Results. Whereas maximum lingual isometric pressures decreased with age (p < .001), no significant age difference was found for swallowing pressure. Time taken to reach peak pressure also was reduced with age in both the isometric task and swallows of liquid boluses (p < .05), while no significant age effect was found for semisolid swallows. Finally, only elderly subjects showed a pattern of liquid swallowing pressure generation in which multiple lingual gestures were required to reach peak pressure (termed "pressure building"), a pattern demonstrated by both young and elderly groups for semisolids. Conclusions. Decreased lingual strength with age combined with unchanging swallowing pressure leads to a decreased "pressure reserve," perhaps leaving older individuals more at risk for dysphagia resulting from insults directly or indirectly to the swallowing system. Additionally, swallowing is generally "slowed" with age, apparently due to both central and peripheral factors, and this change may have an impact on bolus flow outcomes. C1 William S Middleton Mem Vet Hosp, GRECC 11G, Madison, WI 53705 USA. Univ Wisconsin, Inst Aging, Madison, WI USA. Univ Wisconsin, Dept Med, Madison, WI USA. Univ Wisconsin, Dept Biostat, Madison, WI USA. Univ Wisconsin, Dept Surg, Madison, WI USA. RP Nicosia, MA (reprint author), William S Middleton Mem Vet Hosp, GRECC 11G, Madison, WI 53705 USA. FU NIA NIH HHS [TG AG00213]; NINDS NIH HHS [R01 NS24427] NR 35 TC 146 Z9 151 U1 0 U2 6 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD NOV PY 2000 VL 55 IS 11 BP M634 EP M640 PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 373WH UT WOS:000165312700010 PM 11078092 ER PT J AU Stehman-Breen, CO Sherrard, DJ Alem, AM Gillen, DL Heckbert, SR Wong, CS Ball, A Weiss, NS AF Stehman-Breen, CO Sherrard, DJ Alem, AM Gillen, DL Heckbert, SR Wong, CS Ball, A Weiss, NS TI Risk factors for hip fracture among patients with end-stage renal disease SO KIDNEY INTERNATIONAL LA English DT Article DE bone disease; dialysis; epidemiology; renal osteodystrophy; USRDS Study Wave 1 ID BONE-MINERAL DENSITY; RACIAL-DIFFERENCES; OSTEOPOROTIC FRACTURES; HEMODIALYSIS-PATIENTS; PHYSICAL-ACTIVITY; OLDER WOMEN; BLACK-WOMEN; WHITE; MEN; OSTEODYSTROPHY AB Background Although bone disease is well described among end-stage renal disease (ESRD) patients, little attention has been paid to the occurrence of fracture. We sought to identify factors that are associated with hip fracture among ESRD patients. Methods. Data from patients who participated in the United States Renal Data System Dialysis Morbidity and Mortality Study Wave 1 were used for this study. Hip fractures occurring among these patients between 1993 and 1996 were identified from Medicare claims data available from the United States Renal Data System. Cox proportional hazards models were used to estimate the risk of hip fracture associated with demographic and medical variables. Results. Of the 4952 patients included in this analysis, 103 sustained a hip fracture. In the multivariate analysis, age (per increasing decade, RR = 1.40, 95% CI 1.20, 1.64), female gender (RR = 2.26, 95% CI 1.48, 3.44), race (blacks compared with whites, RR = 0.58, 95% CI 0.37, 0.91), body mass index (per 1 unit increase, RR 0.89, 95% CI 0.86, 0.93), and the presence of peripheral vascular disease (RR 1.94, 95% CI 1.29, 2.92) were independently associated with hip fracture. Serum intact parathyroid hormone (iPTH), aluminum, diabetes, and bicarbonate levels did not appreciably influence the risk of hip fracture. Conclusions. Demographic and other characteristics that predict risk of hip fracture in the population at large also do so in ESRD patients. However, we could identify no characteristics of ESRD or its treatment that were independently related to hip fracture incidence. C1 Univ Washington, Sch Publ Hlth & Community Med, Div Nephrol, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth & Community Med, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth & Community Med, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Childrens Hosp & Med Ctr, Div Pediat Nephrol, Seattle, WA 98195 USA. RP Stehman-Breen, CO (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,Mailstop 111A, Seattle, WA 98108 USA. FU NIDDK NIH HHS [DK07721-6] NR 42 TC 150 Z9 153 U1 2 U2 3 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD NOV PY 2000 VL 58 IS 5 BP 2200 EP 2205 DI 10.1046/j.1523-1755.2000.00394.x PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 369CP UT WOS:000090154500040 PM 11044242 ER PT J AU Muzaffar, K Collins, SL Labropoulos, N Baker, WH AF Muzaffar, K Collins, SL Labropoulos, N Baker, WH TI A prospective study of the effects of irradiation on the carotid artery SO LARYNGOSCOPE LA English DT Article; Proceedings Paper CT 103rd Annual Meeting of the American-Laryngological-Rhinological-and-Otological-Society CY MAY 13-18, 2000 CL ORLANDO, FLORIDA SP Amer Laryngol Rhinol & Otol Soc DE carotid artery; head and neck cancer; irradiation ID EXTERNAL CERVICAL IRRADIATION; DISEASE; NECK; HEAD; ATHEROSCLEROSIS; RADIOTHERAPY; THICKNESS; INJURY AB Objectives/Hypothesis: To prospectively assess the effects of irradiation on the carotid artery in patients with head and neck cancer, as a possibly relevant factor in cancer treatment planning. Study Design: Prospective study from a tertiary care academic setting on university (22 patients) and Veterans Affairs (14 patients) hospital patients; 1-year follow-up, including comparison of study data with age-matched and sex-matched control subjects from epidemiological studies, Methods: Thirty-six patients with head and neck cancer who underwent therapeutic neck irradiation were examined by high-resolution ultrasound before and 1 year after treatment. Twelve patients were also studied at 2 years. Measurements included the intima-media thickness (IMT) of the carotid artery wall, the degree of stenosis as estimated from velocity measurements, and the presence and size of plaque. Results: The pretreatment carotid IMT at baseline was 0.68 mm and was comparable to age-matched and sex-matched control subjects. Significant increase in the IMT was observed on both the left (0.67 vs. 0.84 mm) and the right (0.7 vs. 0.87 mm) sides (P < .001) 1 year after irradiation. In 12 patients who completed 24 months of follow-up the carotid IMT continued to significantly increase statistically compared with that at the first year after treatment (left side, 0.79 vs, 0.85 mm, P = .037; right side, 0.79 vs. 0,95 mm, P =, 014), Statistically significant thickening of the carotid wall developed in all 36 patients by 1 year. Two patients experienced post-treatment neurological events and an area of stenosis greater than 75%. Conclusions: Neck. irradiation significantly increases the thickness of the carotid wall during the first year after treatment-on average, 21 times more than in epidemiologically matched control volunteers. This phenomenon should be taken into consideration when planning treatment for the node-negative (NO) neck. C1 Loyola Univ, Ctr Med, Dept Otolaryngol Head & Neck Surg, Maywood, IL 60153 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. RP Muzaffar, K (reprint author), Loyola Univ, Ctr Med, Dept Otolaryngol Head & Neck Surg, Maywood, IL 60153 USA. NR 19 TC 53 Z9 56 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0023-852X J9 LARYNGOSCOPE JI Laryngoscope PD NOV PY 2000 VL 110 IS 11 BP 1811 EP 1814 DI 10.1097/00005537-200011000-00007 PG 4 WC Medicine, Research & Experimental; Otorhinolaryngology SC Research & Experimental Medicine; Otorhinolaryngology GA 371EL UT WOS:000165165200007 PM 11081590 ER PT J AU Weinrieb, RM Van Horn, DHA McLellan, AT Lucey, MR AF Weinrieb, RM Van Horn, DHA McLellan, AT Lucey, MR TI Interpreting the significance of drinking by alcohol-dependent liver transplant patients: Fostering candor is the key to recovery SO LIVER TRANSPLANTATION LA English DT Article ID PSYCHOLOGICAL HEALTH; CIRRHOSIS; DISEASE; RECIDIVISM; RECIPIENTS; SELECTION AB Few studies have examined the value of treating alcohol addiction either before or after liver transplantation. Nevertheless, most liver transplant programs and many insurance companies require 6 months to 1 year of abstinence from alcohol as a condition of eligibility for liver transplantation (the 6-month rule). We believe there are potentially harsh clinical consequences to the implementation of this rule. For example, the natural history of alcohol use disorders often involves brief fallbacks to drinking ("slips"), but when alcoholic liver transplant candidates slip, most are removed from consideration for transplantation or are required to accrue another 6 months of sobriety. Because there is no alternative treatment to liver transplantation for most patients with end-stage liver disease, the 6-month rule could be lethal in some circumstances. In this review, we survey the literature concerning the ability of the 6-month rule to predict drinking by alcoholic patients who undergo liver transplantation and examine its impact on the health consequences of drinking before and after liver transplantation. We believe that fostering candor between the alcoholic patient and the transplant team is the key to recovery from alcoholism. We conclude that it is unethical to force alcoholic liver patients who have resumed alcohol use while waiting for or after transplantation to choose between hiding their drinking to remain suitable candidates for transplantation or risk death by asking for treatment of alcoholism. Consequently, we advocate a flexible approach to clinical decision making for the transplant professional caring for an alcoholic patient who has resumed drinking and provide specific guidelines for patient management. C1 Univ Penn, Treatment Res Ctr, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Weinrieb, RM (reprint author), Univ Penn, Treatment Res Ctr, Sch Med, Dept Med, 3900 Chestnut St, Philadelphia, PA 19104 USA. FU NIAAA NIH HHS [1R01AA12299-01]; NIDA NIH HHS [DA07705] NR 27 TC 54 Z9 54 U1 2 U2 2 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1527-6465 J9 LIVER TRANSPLANT JI Liver Transplant. PD NOV PY 2000 VL 6 IS 6 BP 769 EP 776 DI 10.1053/jlts.2000.18497 PG 8 WC Gastroenterology & Hepatology; Surgery; Transplantation SC Gastroenterology & Hepatology; Surgery; Transplantation GA 374XU UT WOS:000165370800015 PM 11084066 ER PT J AU Rosen, HR AF Rosen, HR TI Retransplantation for hepatitis C: Implications of different policies SO LIVER TRANSPLANTATION LA English DT Article ID LIVER-TRANSPLANTATION AB 1. Approximately 20% of hepatitis C virus (HCV)-positive liver transplant recipients develop evidence of allograft cirrhosis by year 5. 2. The prevalence of HCV infection in patients undergoing retransplantation has significantly increased since 1990. 3. Retransplantation for recurrent HCV is associated with poor long-term survival. 4. Preoperative hyperbilirubinemia (billirubin greater than or equal to5 mg/ dL) and renal failure predict poor outcome after retransplantation. 5. Retransplantation is the only viable option for patients in whom allografts fail because of recurrent HCV disease. C1 Portland State Univ, Portland Vet Affairs Med Ctr, Div Gastroenterol Hepatol, Portland, OR 97207 USA. Portland State Univ, Portland Vet Affairs Med Ctr, Liver Transplantat Program, Portland, OR 97207 USA. RP Rosen, HR (reprint author), Portland State Univ, Portland Vet Affairs Med Ctr, Div Gastroenterol Hepatol, 3710 SW US Vet Hosp Rd,POB 1034,P3-GI, Portland, OR 97207 USA. NR 18 TC 14 Z9 14 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1527-6465 J9 LIVER TRANSPLANT JI Liver Transplant. PD NOV PY 2000 VL 6 IS 6 SU 2 BP S41 EP S46 DI 10.1053/jlts.2000.18689 PG 6 WC Gastroenterology & Hepatology; Surgery; Transplantation SC Gastroenterology & Hepatology; Surgery; Transplantation GA 375WE UT WOS:000165423600008 PM 11084084 ER PT J AU Pearson, ML Lee, JL Chang, BL Elliott, M Kahn, KL Rubenstein, LV AF Pearson, ML Lee, JL Chang, BL Elliott, M Kahn, KL Rubenstein, LV TI Structured implicit review - A new method for monitoring nursing care quality SO MEDICAL CARE LA English DT Review DE nursing care; quality of health care; peer review; implicit review; processes of care ID PROSPECTIVE PAYMENT SYSTEM; DEPRESSED ELDERLY PATIENTS; PEER ASSESSMENTS; MEDICAL-RECORD; HOSPITAL-CARE; RELIABILITY; APPROPRIATENESS; IMPLEMENTATION; JUDGMENTS; EVENTS AB BACKGROUND. Nurses' independent decisions about assessment, treatment, and nursing interventions for hospitalized patients are important determinants of quality of care. Physician peer implicit review of medical records has been central to Medicare quality management and is considered the gold standard far reviewing physician care, but peer implicit review of nursing processes of care has not received similar attention. OBJECTIVE. The objective of this study was to develop and evaluate nurse structured implicit review (SIR) methods. RESEARCH DESIGN. We developed SIR instruments for rating the quality of inpatient nursing care for congestive heart failure (CHF) and cerebrovascular accident (CVA). Nurse reviewers used the SIR form to rate a nationally representative sample of randomly selected medical records for each disease from 297 acute care hospitals in 5 states (collected by the RAND-HCFA Prospective Payment System study). SUBJECTS. The study subjects were elderly Medicare inpatients with CHF (n = 291) or CVA (n = 283). MEASURES. We developed and tested scales reflecting domains of nursing process, evaluated interrater and interitem reliability, and assessed the extent to which items and scales predicted overall ratings of the quality of nursing care. RESULTS. Interrater reliability for 14 of 16 scales (CHF) or 10 of 16 scales (CVA) was greater than or equal to0.40. Interitem reliability was >0.80 for all but 1 scale (both diseases). Functional Assessment, Physical Assessment, and Medication Tracking ratings were the strongest predictors of overall nursing quality ratings (P < 0.001 for each). CONCLUSIONS. Nurse peer review with SIR has adequate interrater and excellent scale reliabilities and can be a valuable tool for assessing nurse performance. C1 RAND Corp, RAND Hlth, Santa Monica, CA 90407 USA. Univ Michigan, Sch Nursing, Undergrad Program, Ann Arbor, MI 48109 USA. Univ Michigan, Sch Nursing, Non Trad Program, Ann Arbor, MI 48109 USA. Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles, Dept Med, Los Angeles, CA USA. RP Pearson, ML (reprint author), RAND Corp, RAND Hlth, POB 2138,1700 Main St, Santa Monica, CA 90407 USA. FU NINR NIH HHS [1-R01-NR-3681-01] NR 69 TC 23 Z9 23 U1 2 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD NOV PY 2000 VL 38 IS 11 BP 1074 EP 1091 DI 10.1097/00005650-200011000-00003 PG 18 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 368UF UT WOS:000090135400003 PM 11078049 ER PT J AU Harada, ND Chun, A Chiu, V Pakalniskis, A AF Harada, ND Chun, A Chiu, V Pakalniskis, A TI Patterns of rehabilitation utilization after hip fracture in acute hospitals and skilled nursing facilities SO MEDICAL CARE LA English DT Article DE physical therapy; hip fracture ID PROSPECTIVE PAYMENT; RACIAL-DIFFERENCES; ELDERLY PATIENTS; SUBACUTE CARE; MANAGED CARE; OUTCOMES; STROKE; MEDICARE AB BACKGROUND. Hospitalized hip fracture patients may receive physical therapy (PT) in acute and/or postacute settings. Patterns of PT use may vary by patient, clinical, and hospital characteristics. These patterns can be analyzed if the acute and postacute stays are linked. OBJECTIVES. We classified the following patterns of PT use: acute PT only, skilled nursing facility (SNF) PT only, acute and SNF PT, and no PT. For each pattern, we compared (1) characteristics of hip fracture patients, (2) length of stay (LOS), and (3) discharge outcomes. SUBJECTS. The study included 187,990 hospitalized hip fracture patients derived from Medicare administrative data. MEASURES. Dependent variables were PT use patterns, acute hospital and SNF LOS, total episode days of care, and discharge destination. Independent variables were demographic, clinical, and facility characteristics. PT use patterns were also used as independent variables in the LOS and discharge destination models. RESULTS. Patterns of PT use were influenced by demographic and clinical characteristics such as age, race, and surgery type. Similarly, different LOS measures and discharge destinations varied by the PT use patterns. Patients receiving acute PT had longer acute LOSs; however, those patients who were subsequently transferred to SNFs had shorter SNF LOSs and total episode days of care. Patients utilizing PT were more likely to be discharged to home after the acute or SNF stay. CONCLUSIONS. Disparities in PT use exist for subgroups of patients such as the elderly and blacks. Providers should determine the most appropriate setting for initiation of PT to achieve better discharge outcomes with efficient use of resources. C1 Univ Calif Los Angeles, Sch Med, GRECC 11G, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Cedars Sinai Med Ctr, Resource & Outcomes Management Dept, Los Angeles, CA 90048 USA. Univ Calif Los Angeles, Sch Med, Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90048 USA. RP Harada, ND (reprint author), Univ Calif Los Angeles, Sch Med, GRECC 11G, VA Greater Los Angeles Hlth Care Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 38 TC 37 Z9 37 U1 1 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD NOV PY 2000 VL 38 IS 11 BP 1119 EP 1130 DI 10.1097/00005650-200011000-00006 PG 12 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 368UF UT WOS:000090135400006 PM 11078052 ER PT J AU Walker, RH Danisi, FO Swope, DM Goodman, RR Germano, IM Brin, MF AF Walker, RH Danisi, FO Swope, DM Goodman, RR Germano, IM Brin, MF TI Intrathecal baclofen for dystonia: Benefits and complications during six years of experience SO MOVEMENT DISORDERS LA English DT Article DE intrathecal baclofen; dystonia ID INTRACTABLE SPINAL SPASTICITY; MULTIPLE-SCLEROSIS CLINICS; GENERALIZED DYSTONIA; CORD SPASTICITY; CEREBRAL-PALSY; INFUSION; SUICIDE; ORIGIN; PATIENT; MANAGEMENT AB Fourteen patients with primary or secondary dystonia received intrathecal baclofen (ITB) through an implanted pump following a trial dose. Patients were selected for ITB trial if they had clinically unsatisfactory responses to oral antidystonic medications, including oral baclofen. Patients were rated using the Burke-Fahn-Marsden rating scale by a blinded rater after the dose of ITB was optimized. Five patients experienced improvement in symptoms as determined by a change in rating scale scores, although only two had a clear clinical benefit. Etiology of dystonia did not determine the efficacy of ITB therapy, as benefit or failure was seen in both primary and secondary dystonia. C1 Mt Sinai Med Ctr, Dept Neurol, New York, NY 10029 USA. Mt Sinai Med Ctr, Dept Neurosurg, New York, NY 10029 USA. Loma Linda Univ, Dept Neurol, Loma Linda, CA 92350 USA. Columbia Univ, Dept Neurol Surg, New York, NY USA. RP Walker, RH (reprint author), Bronx Vet Affairs Med Ctr, Dept Neurol 127, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. FU NCRR NIH HHS [5-MO1-RR00071] NR 52 TC 57 Z9 60 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD NOV PY 2000 VL 15 IS 6 BP 1242 EP 1247 DI 10.1002/1531-8257(200011)15:6<1242::AID-MDS1028>3.0.CO;2-Z PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 372MD UT WOS:000165236700028 PM 11104213 ER PT J AU Royall, DR AF Royall, DR TI Executive cognitive impairment: A novel perspective on dementia SO NEUROEPIDEMIOLOGY LA English DT Review DE cognitive impairment, executive; executive function; frontal lobe; aging; dementia, diagnosis ID QUANTITATIVE CEREBRAL ANATOMY; ALZHEIMERS-DISEASE; ELDERLY SUBJECTS; SYNAPSE LOSS; BEHAVIOR; DEPRESSION; DYSCONTROL; SEVERITY; FEATURES AB In 1994 the American Psychiatric Association added impairment of executive control functions (ECF) to its list of cognitive domains that should be considered in the assessment of dementia, This recommendation has not been widely implemented. None the less, there is growing evidence that ECF impairment is common, strongly associated with disability and functional decline, and not well detected by traditional dementia screening tests. This article reviews the implications of ECF for the epidemiology of dementia. The total number of dementia cases may be much greater than previously thought and we are likely to be selectively missing cases with reversible causes of ECF impairment. Copyright (C) 2000 S. Karger AG, Basel. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78229 USA. S Texas Vet Hlth Syst Audie L Murphy Div GRECC, Dept Psychiat, San Antonio, TX USA. S Texas Vet Hlth Syst Audie L Murphy Div GRECC, Dept Med, San Antonio, TX USA. S Texas Vet Hlth Syst Audie L Murphy Div GRECC, Dept Pharmacol, San Antonio, TX USA. RP Royall, DR (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 40 TC 72 Z9 77 U1 4 U2 6 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 0251-5350 J9 NEUROEPIDEMIOLOGY JI Neuroepidemiology PD NOV-DEC PY 2000 VL 19 IS 6 BP 293 EP 299 DI 10.1159/000026268 PG 7 WC Public, Environmental & Occupational Health; Clinical Neurology SC Public, Environmental & Occupational Health; Neurosciences & Neurology GA 371UA UT WOS:000165195700002 PM 11060503 ER PT J AU Ferrer, RL Sibai, BM Mulrow, CD Chiquette, E Stevens, KR Cornell, J AF Ferrer, RL Sibai, BM Mulrow, CD Chiquette, E Stevens, KR Cornell, J TI Management of mild chronic hypertension during pregnancy: A review SO OBSTETRICS AND GYNECOLOGY LA English DT Review ID LOW-DOSE ASPIRIN; CONVERTING ENZYME-INHIBITORS; RANDOMIZED CONTROLLED TRIAL; HIGH-RISK PREGNANCY; LOW-BIRTH-WEIGHT; LATE FETAL DEATH; ABRUPTIO PLACENTAE; ANTIHYPERTENSIVE TREATMENT; MODERATE HYPERTENSION; MATERNAL HYPERTENSION AB Objective: To conduct a systematic review of evidence relating to management of mild chronic hypertension during pregnancy, including associated risks, benefits, and harms of treatment with antihypertensive agents, nonpharmacologic measures, and aspirin and benefits of various monitoring strategies. Data Sources: Using four broad search strategies, we searched English and non-English-language citations in 16 electronic databases from their inception to February 1999 and consulted relevant textbooks, references, and experts. Study Selection: Reviewers screened 6228 abstracts and found 215 articles that met multiple prespecified patient selection, study population, and design criteria. Tabulation, Integration, and Results: Forty-six studies consistently showed that chronic hypertension triples the risk for perinatal mortality (odds ratio [OR] 3.4; 95% confidence interval [CI] 3.0, 3.7) and doubles the risk for placental abruption (OR 2.1; 95% CI 1.1, 3.9). Thirteen small, randomized controlled trials had inadequate power to rule in or rule out moderate-to-large (20%-50%) benefits of antihypertensive treatment. Possible adverse effects were fetal renal failure when angiotensin-converting enzyme inhibitors are used in the second or third trimester and growth restriction when atenolol is used early in pregnancy. Trials showed that aspirin neither reduces nor increases perinatal and maternal morbidity, but they did not rule out possible small-to moderate beneficial or adverse effects. No studies provide guidance on benefits or consequences of various nonpharmacologic therapies or monitoring strategies. Conclusion: Mild chronic hypertension is associated with increased maternal and fetal risks. Beneficial treatment and monitoring regimens are not clear, but some treatments, such as angiotensin-converting enzyme inhibitors, are best avoided. (Obstet Gynecol 2000;96:849-60. (C) 2000 by The American College of Obstetricians and Gynecologists.). C1 Univ Texas, Hlth Sci Ctr, Dept Family Med, San Antonio, TX USA. Univ Tennessee, Div Obstet & Gynecol, Memphis, TN USA. Univ Texas, Hlth Sci Ctr, Div Gen Med, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Vet Evidence Based Res Disseminat & Implementat C, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Sch Nursing, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Div Geriatr & Gerontol, San Antonio, TX USA. RP Ferrer, RL (reprint author), Audie L Murphy Mem Vet Hosp, 11C,7400 Merton Minter Blvd, San Antonio, TX 78284 USA. RI Ferrer, Robert/A-6854-2009 NR 113 TC 76 Z9 81 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD NOV PY 2000 VL 96 IS 5 SU S BP 849 EP 860 DI 10.1016/S0029-7844(00)00938-8 PN 2 PG 12 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 368QX UT WOS:000090130000030 PM 11094241 ER PT J AU Martinez, V Tache, Y AF Martinez, V Tache, Y TI Bombesin and the brain-gut axis SO PEPTIDES LA English DT Article DE amphibian skin peptides; regulatory peptides; gut function; gastric secretion; gastric motility; hypothalamic nuclei; vague nerve; autonomic pathways ID GASTRIC-ACID SECRETION; CENTRAL-NERVOUS-SYSTEM; DORSAL VAGAL COMPLEX; THYROTROPIN-RELEASING-HORMONE; INTRACISTERNAL BOMBESIN; ADMINISTERED BOMBESIN; MAMMALIAN BOMBESIN; MOTOR NUCLEUS; PARAVENTRICULAR NUCLEUS; RAT-BRAIN AB Bombesin is the first peptide shown to act in the brain to influence gastric function and the most potent peptide to inhibit acid secretion when injected into the cerebrospinal fluid (CSF) in rats and dogs. Bombesin responsive sites include specific hypothalamic nuclei (paraventricular nucleus, preoptic area and anterior hypothalamus), the dorsal vagal complex as well as spinal sites at T9-T10. The antisecretory effect of central bombesin encompasses a variety of endocrine/paracrine (gastrin, histamine) or neuronal stimulants. Bombesin into the CSF induces an integrated gastric response (increase in bicarbonate, and mucus, inhibition of acid, pepsin, vagally mediated contractions) enhancing the resistance of the mucosa to injury through autonomic pathways. The physiological significance of central action of bombesin on gastric function is still to be unraveled. (C) 2000 Elsevier Science Inc. All rights reserved. C1 Univ Calif Los Angeles, Sch Med, CURE Digest Dis Res Ctr,Digest Dis Div, VA Greater Los Angeles Healthcare Syst,Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90073 USA. CEU San Pablo, Sch Vet, Dept Physiol, Valencia 46113, Spain. RP Tache, Y (reprint author), Univ Calif Los Angeles, Sch Med, CURE Digest Dis Res Ctr,Digest Dis Div, VA Greater Los Angeles Healthcare Syst,Dept Med, Los Angeles, CA 90073 USA. RI Martinez, Vicente/N-1189-2014 FU NIDDK NIH HHS [DK-30110, DK-41301] NR 90 TC 23 Z9 25 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0196-9781 J9 PEPTIDES JI Peptides PD NOV PY 2000 VL 21 IS 11 BP 1617 EP 1625 DI 10.1016/S0196-9781(00)00293-X PG 9 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy GA 379UK UT WOS:000165660800005 PM 11090915 ER PT J AU Chou, CT Schumacher, HR AF Chou, CT Schumacher, HR TI Human leucocyte antigens (class I and II) in central Taiwan aborigines: can these explain the observed differences in rheumatic disease patterns compared with Han Chinese? SO RHEUMATOLOGY LA English DT Letter C1 Vet Gen Hosp, Div Rheumatol Allergy & Immunol, Dept Med, Taipei 11217, Taiwan. Univ Penn, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Arthrit Immunol Ctr, Philadelphia, PA 19104 USA. RP Chou, CT (reprint author), Vet Gen Hosp, Div Rheumatol Allergy & Immunol, Dept Med, 201 Sec 2,Shih Pai Rd, Taipei 11217, Taiwan. NR 10 TC 7 Z9 7 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1462-0324 J9 RHEUMATOLOGY JI RHEUMATOLOGY PD NOV PY 2000 VL 39 IS 11 BP 1297 EP 1299 DI 10.1093/rheumatology/39.11.1297 PG 3 WC Rheumatology SC Rheumatology GA 377NW UT WOS:000165520500028 PM 11085819 ER PT J AU Kohlmeier, RE Cho, CG Bux, RC Guerra, L Rulon, JJ Selby, DM Gulley, ML AF Kohlmeier, RE Cho, CG Bux, RC Guerra, L Rulon, JJ Selby, DM Gulley, ML TI Prothrombin gene mutation uncommon in pulmonary embolism SO SOUTHERN MEDICAL JOURNAL LA English DT Article ID FACTOR-V-LEIDEN; DEEP VENOUS THROMBOSIS; 3'-UNTRANSLATED REGION; GLN MUTATION; VARIANT; ALLELE; PREVALENCE; CARRIERS; RISK; ARG-506 AB Background. Venous thrombosis followed by pulmonary embolism is one of the most common causes of sudden death among middle-aged adults. Several inherited polymorphisms are associated with heightened risk of venous thrombosis, including mutation at position 20210 of the prothrombin gene and mutation at codon 506 of the factor V gene. Methods. We studied mutation prevalence in 67 individuals who died of pulmonary embolism and were autopsied in a medical examiner's facility over a 5-year period. Mutations were identified by polymerase chain reaction followed by allele-specific endonuclease digestion. Results. Traditional risk factors fur pulmonary embolism (eg, immobility, oral contraceptive use, cancer) were identified in 75%. Heterozygous mutation of the prothrombin gene was found in 3/67 (4%), and heterozygous mutation of the factor V gene was identified in 3/66 (4%). No homozygotes or compound heterozygotes were identified. The prevalence of mutation was not significantly different from that of the general population Conclusions. Individuals who die suddenly from pulmonary embolism are not often affected by prothrombin or factor V gene mutations. Therefore, medical examiners need not routinely test for these mutations in individuals who die of pulmonary embolism. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, Bexar Cty Forens Sci Ctr,Wilford Hall Med Ctr, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Hosp, San Antonio, TX USA. RP Gulley, ML (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, Bexar Cty Forens Sci Ctr,Wilford Hall Med Ctr, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. NR 17 TC 5 Z9 5 U1 0 U2 0 PU SOUTHERN MEDICAL ASSN PI BIRMINGHAM PA 35 LAKESHORE DR PO BOX 190088, BIRMINGHAM, AL 35219 USA SN 0038-4348 J9 SOUTHERN MED J JI South.Med.J. PD NOV PY 2000 VL 93 IS 11 BP 1073 EP 1077 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 376AW UT WOS:000165436500005 PM 11095555 ER PT J AU Sachs, G Scott, D Weeks, D Melchers, K AF Sachs, G Scott, D Weeks, D Melchers, K TI Gastric habitation by Helicobacter pylori: insights into acid adaptation SO TRENDS IN PHARMACOLOGICAL SCIENCES LA English DT Article ID PROTON MOTIVE FORCE; UREASE ACTIVITY; PH; SURVIVAL C1 VA Greater LA Healthcare Syst, Los Angeles, CA 90073 USA. BYK Gulden Lomberg GmbH, D-7750 Constance, Germany. RP Sachs, G (reprint author), VA Greater LA Healthcare Syst, Bldg 113,Room 314,11310 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 22 TC 8 Z9 8 U1 0 U2 1 PU ELSEVIER SCIENCE LONDON PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0165-6147 J9 TRENDS PHARMACOL SCI JI Trends Pharmacol. Sci. PD NOV PY 2000 VL 21 IS 11 BP 413 EP 416 DI 10.1016/S0165-6147(00)01554-6 PG 4 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 374GD UT WOS:000165336700002 PM 11121568 ER PT J AU Freedland, SJ Dorey, F Aronson, WJ AF Freedland, SJ Dorey, F Aronson, WJ TI Multivariate analysis of race and adverse pathologic findings after radical prostatectomy SO UROLOGY LA English DT Article ID POSITIVE SURGICAL MARGINS; PROGNOSTIC FACTOR; AFRICAN-AMERICAN; CANCER; ANTIGEN; CARCINOMA; WHITE; SPECIMENS; SURVIVAL; STAGE AB Objectives. Adverse pathologic features that predict disease recurrence after radical prostatectomy (RP) include positive surgical margins, non-organ-confined disease, and seminal vesicle invasion. Given that black men have a higher incidence of, and mortality from, prostate cancer compared with white men, we sought to determine whether race was an independent predictor of adverse pathologic findings among men who underwent RP at an equal access health care center. Results from previous studies evaluating whether race predicts positive surgical margins have been conflicting. No prior studies have evaluated whether race is an independent predictor of non-organ-confined disease or seminal vesicle invasion. Methods, A retrospective survey of 274 patients (126 black, 148 white) who underwent RP at the West Los Angeles Veterans Affairs Medical Center between 1991 and 1999 was undertaken. Multivariate analysis was used to determine the preoperative clinical variables that were most significant in predicting positive surgical margins, non-organ-confined disease, and seminal vesicle invasion. The preoperative variables analyzed were race, age, serum prostate-specific antigen, clinical stage, and biopsy Gleason score. Results. No differences in the incidence of positive surgical margins, non-organ-confined disease, or seminal vesicle invasion were found between black and white men undergoing RP. After controlling for the preoperative variables of age, serum prostate-specific antigen level, clinical stage, and biopsy Gleason score, race was not an independent predictor of positive surgical margins, non-organ-confined disease, or seminal vesicle invasion. Conclusions. This is the first study to show that black race was not an independent predictor of non-organ-confined disease or seminal vesicle invasion among patients undergoing RP. Furthermore, race was not an independent predictor of positive surgical margins. UROLOGY 56: 807-811, 2000. (C) 2000, Elsevier Science Inc. C1 Univ Calif Los Angeles, Sch Med, Dept Urol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Biostat, Los Angeles, CA 90095 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Vet Affairs Med Ctr Sepulveda, Los Angeles, CA USA. RP Aronson, WJ (reprint author), Univ Calif Los Angeles, Sch Med, Dept Urol, Box 951738, Los Angeles, CA 90095 USA. NR 21 TC 18 Z9 18 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0090-4295 J9 UROLOGY JI UROLOGY PD NOV PY 2000 VL 56 IS 5 BP 807 EP 811 DI 10.1016/S0090-4295(00)00754-8 PG 5 WC Urology & Nephrology SC Urology & Nephrology GA 375LK UT WOS:000165400700022 PM 11068307 ER PT J AU Rubin, SA Iacoviello, M Smith, SE Dey, S Chatterjee, N Said, HM AF Rubin, SA Iacoviello, M Smith, SE Dey, S Chatterjee, N Said, HM TI Characterization and cloning of a specific, carrier-mediated system for pantothenic acid uptake by vascular smooth muscle SO CIRCULATION LA English DT Meeting Abstract C1 VA Greater Los Angeles, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. VA Long Beach, Long Beach, CA USA. Univ Calif Irvine, Long Beach, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 81 BP 19 EP 19 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072300082 ER PT J AU Diwan, A Dibbs, ZI Gao, F Nemoto, S Defreitas, G Sivasubramanian, N Carabello, BA Mann, DL AF Diwan, A Dibbs, ZI Gao, F Nemoto, S Defreitas, G Sivasubramanian, N Carabello, BA Mann, DL TI Cardiac restricted overexpression of membrane bound tumor necrosis factor provokes a hypertrophic cardiac phenotype SO CIRCULATION LA English DT Meeting Abstract C1 Winters Ctr Heart Failure Res, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Houston VAMC, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 338 BP 71 EP 71 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072300337 ER PT J AU Nemoto, ST Vallejo, JG Defreitas, G Knuefermann, P Carabello, BA AF Nemoto, ST Vallejo, JG Defreitas, G Knuefermann, P Carabello, BA TI Role of gene deletion of the toll-like receptor-4 (TLR-4) in lipopolysaccharide (LPS)-induced left ventricular dysfunction SO CIRCULATION LA English DT Meeting Abstract C1 Houston VAMC, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 355 BP 74 EP 74 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072300354 ER PT J AU Nozaki, N Nemoto, S Defreitas, G Engel, DJ Baumgarten, G Sivasubramanian, N Carballo, E Blackshear, PJ Carabello, BA Mann, DL AF Nozaki, N Nemoto, S Defreitas, G Engel, DJ Baumgarten, G Sivasubramanian, N Carballo, E Blackshear, PJ Carabello, BA Mann, DL TI Hemodynamic overload induced myocardial cytokine gene regulation occurs through a novel mechanism that involves tristetraprolin SO CIRCULATION LA English DT Meeting Abstract C1 Winters Ctr Heart Failure Res, Houston, TX USA. Houston VAMC, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. NIEHS, NIH, Res Triangle Pk, NC 27709 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 1081 BP 223 EP 223 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072301078 ER PT J AU Durante, W Peyton, PJ Schafer, AI AF Durante, W Peyton, PJ Schafer, AI TI Heme oxygenase-1 is an autocrine inhibitor of vascular smooth muscle cell growth SO CIRCULATION LA English DT Meeting Abstract C1 Baylor Coll Med, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 1457 BP 298 EP 298 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072301451 ER PT J AU Maki, JH Wilson, GJ Lauffer, RB Weisskoff, RM Yuan, C AF Maki, JH Wilson, GJ Lauffer, RB Weisskoff, RM Yuan, C TI Vessel wall enhancement with MS-325 facilitates plaque detection and characterization SO CIRCULATION LA English DT Meeting Abstract C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Epix Med Inc, Cambridge, MA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 1832 BP 375 EP 375 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072301827 ER PT J AU Bozkurt, B Geraci, JM Knowlton, AA AF Bozkurt, B Geraci, JM Knowlton, AA TI Spironolactone use in heart failure: Spiraling out of control? SO CIRCULATION LA English DT Meeting Abstract C1 Baylor Coll Med, VAMC, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 2002 BP 412 EP 412 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072301997 ER PT J AU Klugherz, BD Llanos, G Lieuallen, W Kopia, GA Papandreou, G Narayanan, P Levengood, T Sasseen, BM Adelman, S Carter, AJ Falotico, R Wilensky, RL AF Klugherz, BD Llanos, G Lieuallen, W Kopia, GA Papandreou, G Narayanan, P Levengood, T Sasseen, BM Adelman, S Carter, AJ Falotico, R Wilensky, RL TI Intramural kinetics of sirolimus eluted from an intracoronary stent SO CIRCULATION LA English DT Meeting Abstract C1 Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Cordis Corp, Warren, NJ USA. Hosp Univ Penn, Philadelphia, PA 19104 USA. Wyeth Ayerst, Malvern, PA USA. Stanford Univ, Palo Alto, CA 94304 USA. Univ Penn, Philadelphia, PA 19104 USA. NR 0 TC 3 Z9 4 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 3544 BP 733 EP 733 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072303536 ER PT J AU Rumsfeld, JS Magid, DJ O'Brien, MM Plomondon, ME Parsons, LS Spertus, JA Every, NR Sales, AE AF Rumsfeld, JS Magid, DJ O'Brien, MM Plomondon, ME Parsons, LS Spertus, JA Every, NR Sales, AE TI Predictors of quality of life following acute coronary syndromes SO CIRCULATION LA English DT Meeting Abstract C1 Denver VA Med Ctr, Denver, CO USA. Colorado Permanente Med Grp, Denver, CO USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. St Lukes Hosp, Mid Amer Heart Inst, Kansas City, MO 64111 USA. RI Sales, Anne/D-9678-2012 NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 4080 BP 849 EP 849 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072304071 ER PT J AU Beinart, SC Sales, AE Parsons, LS Spertus, JA Caldwell, DM Every, NR AF Beinart, SC Sales, AE Parsons, LS Spertus, JA Caldwell, DM Every, NR TI Predictors of treatment satisfaction after admission for AMI and unstable angina SO CIRCULATION LA English DT Meeting Abstract C1 Univ Washington, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Missouri, Kansas City, MS USA. RI Sales, Anne/D-9678-2012 NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 4083 BP 850 EP 850 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072304074 ER PT J AU Fong, PP Sales, AE Parsons, LS Spertus, JA Caldwell, DM Every, NR AF Fong, PP Sales, AE Parsons, LS Spertus, JA Caldwell, DM Every, NR TI Functional status in veterans after discharge for unstable angina pectoris versus acute myocardial infarction SO CIRCULATION LA English DT Meeting Abstract C1 Univ Washington, VA Puget Sound Hlth Care, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Missouri, Kansas City, MO 64110 USA. RI Sales, Anne/D-9678-2012 NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 4088 BP 851 EP 851 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072304079 ER PT J AU Oliveria, SA Lapuerta, P McCarthy, BD Whyte, JL Asch, SM L'Italien, GJ AF Oliveria, SA Lapuerta, P McCarthy, BD Whyte, JL Asch, SM L'Italien, GJ TI Physician knowledge and barriers to the effective management of uncontrolled hypertension SO CIRCULATION LA English DT Meeting Abstract C1 Columbia Univ, Weill Med Coll, New York, NY USA. Bristol Myers Squibb Co, Princeton, NJ USA. Henry Ford Hlth Syst, Detroit, MI USA. VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 SU S MA 4108 BP 855 EP 855 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 367QE UT WOS:000090072304099 ER PT J AU Hsia, J Simon, JA Lin, F Applegate, WB Vogt, MT Hunninghake, D Carr, M AF Hsia, J Simon, JA Lin, F Applegate, WB Vogt, MT Hunninghake, D Carr, M CA HERS Investigators TI Peripheral arterial disease in randomized trial of estrogen with progestin in women with coronary heart disease - The heart and estrogen/progestin replacement study SO CIRCULATION LA English DT Article DE hormones; peripheral vascular disease; coronary disease; women ID POSTMENOPAUSAL WOMEN; INTERMITTENT CLAUDICATION; CAROTID ATHEROSCLEROSIS; MYOCARDIAL-INFARCTION; DOUBLE-BLIND; THERAPY; PRAVASTATIN; PROGRESSION; LOVASTATIN; CHOLESTEROL AB Background-Postmenopausal estrogen use has been associated with reduced carotid atherosclerosis in observational studies, but this relationship has not been confirmed in a clinical trial. The impact of estrogen on atherosclerotic disease in other peripheral arteries is unknown. Methods and Results-Postmenopausal women with coronary heart disease (CHD) and an intact uterus (n=2763)were randomly assigned to conjugated equine estrogens (0.625 mg) combined with medroxyprogesterone acetate (2.5 mg) daily or to placebo in a secondary CHD prevention trial. This analysis focuses on incident peripheral arterial procedures and deaths in the 2 treatment groups; peripheral vascular disease was a predefined secondary outcome. During a mean of 4.1 years of follow-up, 311 peripheral arterial events were reported in 213 women, an annual incidence of 2.9%. The number of women who had peripheral arterial events was 99 among those assigned to active estrogen/progestin and 114 among those assigned to placebo, a nonsignificant difference (relative hazard 0.87, 95% CI 0.66 to 1.14), In the placebo group, hypertension and diabetes mellitus were independently associated with higher rates of peripheral arterial events, and plasma HDL cholesterol and body mass index were associated with lower rates of peripheral arterial events. In the estrogen/progestin group, current smoking and diabetes ware independent predictors of peripheral arterial events. Incident peripheral arterial disease was not a significant predictor of coronary, cardiovascular, or total mortality. Conclusions-Treatment with oral conjugated estrogen plus medroxyprogesterone acetate was not associated with a significant reduction in incident peripheral arterial events in postmenopausal women with preexisting CHD. C1 George Washington Univ, Dept Med, Washington, DC 20052 USA. San Francisco VA Med Ctr, Dept Gen Internal Med, San Francisco, CA USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Wake Forest Univ, Dept Med, Winston Salem, NC 27109 USA. Univ Pittsburgh, Sch Med, Dept Orthopaed Surg, Pittsburgh, PA 15261 USA. Univ Minnesota, Heart Dis Prevent Clin, Minneapolis, MN USA. San Francisco VA Med Ctr, Dept Gen Internal Med, San Francisco, CA USA. RP Hsia, J (reprint author), 2150 Penn Ave NW 4-414, Washington, DC 20037 USA. NR 27 TC 44 Z9 45 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD OCT 31 PY 2000 VL 102 IS 18 BP 2228 EP 2232 PG 5 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 368GM UT WOS:000090109400021 PM 11056097 ER PT J AU Lai, EC Jankovic, J Krauss, JK Ondo, WG Grossman, RG AF Lai, EC Jankovic, J Krauss, JK Ondo, WG Grossman, RG TI Long-term efficacy of posteroventral pallidotomy in the treatment of Parkinson's disease SO NEUROLOGY LA English DT Article AB The authors describe results of unilateral posteroventral pallidotomy (PVP) in 89 patients with PD. At 3 months after surgery, 81.9% of the patients reported marked or moderate improvement in their parkinsonian symptoms. Postoperative Unified PD Rating Scale "off" state mean total motor score improved by 35.5% and the mean activities of daily living score by 33.7% (p < 0,001). Improvements in parkinsonian symptoms were maintained in both "off" and "on" states in 62 patients at 12 months after PW and in 41 patients who were followed for 18 months or longer (mean 26.6 months). C1 Houston Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Methodist Hosp, Dept Neurol, Houston, TX 77030 USA. Baylor Coll Med, Methodist Hosp, Dept Neurosurg, Houston, TX 77030 USA. RP Lai, EC (reprint author), Baylor Coll Med, Dept Neurol, 6550 Fannin,Suite 1801, Houston, TX 77030 USA. NR 10 TC 35 Z9 36 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD OCT 24 PY 2000 VL 55 IS 8 BP 1218 EP 1222 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 366PB UT WOS:000090012800027 PM 11071505 ER PT J AU Brand, JG AF Brand, JG TI Within reach of an end to unnecessary bitterness? SO LANCET LA English DT Editorial Material ID TASTE; GUSTDUCIN C1 Monell Chem Senses Ctr, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Penn, Philadelphia, PA 19104 USA. RP Brand, JG (reprint author), Monell Chem Senses Ctr, 3500 Market St, Philadelphia, PA 19104 USA. RI Marion-Poll, Frederic/D-8882-2011 OI Marion-Poll, Frederic/0000-0001-6824-0180 NR 20 TC 8 Z9 8 U1 0 U2 1 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD OCT 21 PY 2000 VL 356 IS 9239 BP 1371 EP 1372 DI 10.1016/S0140-6736(00)02836-1 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 365XQ UT WOS:000089976100005 PM 11052575 ER PT J AU Vallee, JP AF Vallee, JP TI Complete coloscopy for colorectal cancer screening? SO PRESSE MEDICALE LA French DT Editorial Material C1 Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Div Gastroenterol, Portland, OR 97207 USA. RP Vallee, JP (reprint author), Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Div Gastroenterol, P-3-GI,POB 1034, Portland, OR 97207 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MASSON EDITEUR PI PARIS 06 PA 120 BLVD SAINT-GERMAIN, 75280 PARIS 06, FRANCE SN 0755-4982 J9 PRESSE MED JI Presse Med. PD OCT 21 PY 2000 VL 29 IS 31 BP 1707 EP 1707 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 368ZH UT WOS:000090147000008 PM 11094616 ER PT J AU Schwartz, GG AF Schwartz, GG TI Exploring new strategies for the management of acute coronary syndromes SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article; Proceedings Paper CT Symposium on New Directions in the Understanding and Management of Acute Coronary Syndromes CY MAR 24, 2000 CL TORONTO, CANADA ID ACUTE MYOCARDIAL-INFARCTION; GLUCOSE-INSULIN-POTASSIUM; RANDOMIZED TRIAL; UNSTABLE ANGINA; THERAPY; REPERFUSION; DISEASE; ATHEROSCLEROSIS; ATORVASTATIN; ENDOTHELIUM AB Patients who present today with an acute coronary syndrome face a substantially lower risk of death, recurrent myocardial infarction, or severe ischemia than patients did a decade ago. Researchers are pursuing new strategies to further improve the outcomes of patients with acute coronary syndromes. These strategies may be grouped into 3 paradigms: (1) restoration and maintenance of coronary flow at the site of culprit lesion; (2) reduction of infarct size, reperfusion injury, and postischemic dysfunction; (3) stabilization of the coronary arterial wall and its interaction with the bloodstream to reduce recurrent ischemic events. The last approach encompasses strategies to alter the underlying vascular patho-physiology that leads to plaque instability and coronary thrombosis. Investigation into each of these paradigms may yield new strategies that will be incorporated into standard clinical management of acute coronary syndromes in coming years. With so many mechanistically different approaches to the management of acute coronary syndromes, clinicians have reason for optimism that continued progress will further reduce the morbidity and mortality associated with acute coronary syndromes and the likelihood of their recurrence, (C) 2000 by Excerpta Medica, Inc. C1 Univ Colorado, Hlth Sci Ctr, Denver Vet Affairs Med Ctr, Cardiol Sect 111B, Denver, CO 80220 USA. RP Schwartz, GG (reprint author), Univ Colorado, Hlth Sci Ctr, Denver Vet Affairs Med Ctr, Cardiol Sect 111B, 1055 Clermont St, Denver, CO 80220 USA. NR 36 TC 3 Z9 3 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD OCT 19 PY 2000 VL 86 IS 8B SI SI BP 44J EP 49J PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 372BU UT WOS:000165214400012 PM 11081448 ER PT J AU Ali, NM Raizner, AE Schulz, DG Zymek, P Kaluza, GL AF Ali, NM Raizner, AE Schulz, DG Zymek, P Kaluza, GL TI The effects of intravascular beta-radiation with P-32 in stent injured porcine peripheral arteries. SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Meeting Abstract C1 Baylor Coll Med, Methodist Hosp, Houston, TX 77030 USA. Baylor Coll Med, VA Med Ctr, Cardiol Sect, Dept Med, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD OCT 16 PY 2000 VL 86 IS 8A SI SI MA 326 BP 123I EP 123I PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 373CB UT WOS:000165269800322 ER PT J AU Kaluza, GL Zymek, P Schulz, DG Raizner, AE Ali, NM AF Kaluza, GL Zymek, P Schulz, DG Raizner, AE Ali, NM CA Methodist Hosp VA Med Ctr TI Is "Geographic miss" the mechanism of edge effect after intracoronary radiation? A histologic study. SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Meeting Abstract C1 Baylor Coll Med, Methodist Hosp, Houston, TX 77030 USA. Baylor Coll Med, VA Med Ctr, Cardiol Sect, Dept Med, Houston, TX 77030 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD OCT 16 PY 2000 VL 86 IS 8A SI SI MA 334 BP 126I EP 126I PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 373CB UT WOS:000165269800330 ER PT J AU Saint, S Wiese, J Amory, JK Bernstein, ML Patel, UD Zemencuk, JK Bernstein, SJ Lipsky, BA Hofer, TP AF Saint, S Wiese, J Amory, JK Bernstein, ML Patel, UD Zemencuk, JK Bernstein, SJ Lipsky, BA Hofer, TP TI Are physicians aware of which of their patients have indwelling urinary catheters? SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID NURSING-HOME PATIENTS; TRACT INFECTION; NOSOCOMIAL INFECTIONS; UNITED-STATES; BACTERIURIA AB PURPOSE: Although infections associated with indwelling urinary catheters are common, costly, and morbid, the use of these catheters is unnecessary in more than one-third of patients. We sought to assess whether attending physicians, medical residents, and medical students are aware if their hospitalized patients have an indwelling urinary catheter, and whether physician awareness is associated with appropriate use of these catheters. METHODS: The physicians and medical students responsible for patients admitted to the medical services at four university-affiliated hospitals were given a list of the patients on their service. For each patient, the provider was asked: "As of yesterday afternoon, did this patient have an indwelling urethral catheter?" Respondents' answers were compared with the results of examining the patient. RESULTS: Among 288 physicians and students on 56 medical teams, 256 (89%) completed the survey. Of 469 patients, 117 (25%) had an indwelling catheter. There were a total of 319 provider-patient observations among these 117 patients. Over all, providers were unaware of catheterization for 88 (28%) of the 319 provider-patient observations. Unawareness rates by level of training were 21% for students, 22% for interns, 27% for residents, and 38% for attending physicians (P = 0.06). Catheter use was inappropriate in 36 (31%) of the 117 patients with a catheter. Providers were unaware of catheter use for 44 (41%) of the 108 provider-patient observations of patients who were inappropriately catheterized. Catheterization was more Likely to be appropriate if respondents were aware of the catheter (odds ratio = 3.7; 95% confidence interval, 2.1 to 6.7, P<0.001). CONCLUSION: Physicians are commonly unaware that their patients have an indwelling urinary catheter. Inappropriate catheters are more often "forgotten" than appropriate ones. System-wide interventions aimed at discontinuing unnecessary catheterization seem warranted. Am J Med. 2000;109: 476-480. (C) 2000 by Excerpta Medica, Inc. C1 Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI USA. Univ Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Vet Affairs Ann Arbor Healthcare Syst, Vet Affairs Ctr Practice Management & Outcomes, Ann Arbor, MI USA. Vet Affairs Puget Sound Hlth Care Syst, Primary & Specialty Med Care, Seattle, WA USA. RP Saint, S (reprint author), Univ Michigan Hlth Syst, Taubman Ctr 3116, Box 0376,1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA. OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 23 TC 127 Z9 127 U1 0 U2 2 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD OCT 15 PY 2000 VL 109 IS 6 BP 476 EP 480 DI 10.1016/S0002-9343(00)00531-3 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 367JC UT WOS:000090057100006 PM 11042237 ER PT J AU Gage, BF Fihn, SD White, RH AF Gage, BF Fihn, SD White, RH TI Management and dosing of warfarin therapy SO AMERICAN JOURNAL OF MEDICINE LA English DT Review ID ORAL ANTICOAGULANT-THERAPY; FRESH-FROZEN PLASMA; EXCESSIVE ANTICOAGULATION; VITAMIN-K; RANDOMIZED TRIAL; DECISION-SUPPORT; SUBCUTANEOUS VITAMIN-K-1; OUTPATIENT THERAPY; SELF-MANAGEMENT; STEADY-STATE AB When initiating warfarin therapy, clinicians should avoid loading doses-that can raise the International Normalized Ratio (INR) excessively; instead, warfarin should be initiated with a 5-mg dose (or 2 to 4 mg in the very elderly). With a 5-mg initial dose, the INR will not rise appreciably in the first 24 hours, except in rare patients who will ultimately require a very small daily dose (0.5 to 2.0 mg). Adjusting a steady-slate warfarin dose depends on the measured INR values and clinical factors: the dose does not need to be adjusted for a single INR that is slightly out of range, and most changes should alter the total weekly dose by 5% to 20%. The INR should be monitored frequently (eg, 2 to 4 times per week) immediately after initiation of warfarin; subsequently, the interval between INR tests can be lengthened gradually (up to a maximum of 4 to 6 weeks) in patients with Stable INR values. Patients who have an elevated INR will need more frequent testing and may also require vitamin K1. For example, a nonbleeding patient with an INR of 9 can be given low-dose vitamin K1 (eg, 2.5 mg phytonadione, by mouth). Patients who have an excessive INR with clinically important bleeding require clotting factors leg, fresh-frozen plasma) as well as vitamin K1. Am J Med. 2000;109:481-488. (C) 2000 by Excerpta Medica, Inc. C1 Washington Univ, Sch Med, Div Gen Med Sci, St Louis, MO 63110 USA. Univ Washington, Div Gen Internal Med, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Calif Davis, Div Gen Med, Sacramento, CA 95817 USA. RP Gage, BF (reprint author), Washington Univ, Sch Med, Div Gen Med Sci, Campus Box 8005,660 S Euclid Ave, St Louis, MO 63110 USA. FU AHRQ HHS [HS10133] NR 105 TC 83 Z9 84 U1 2 U2 2 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD OCT 15 PY 2000 VL 109 IS 6 BP 481 EP 488 DI 10.1016/S0002-9343(00)00545-3 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 367JC UT WOS:000090057100007 PM 11042238 ER PT J AU Shiao, T Iwahashi, M Fortune, J Quattrochi, L Bowman, S Wick, M Qadri, I Simon, FR AF Shiao, T Iwahashi, M Fortune, J Quattrochi, L Bowman, S Wick, M Qadri, I Simon, FR TI Structural and functional characterization of liver cell-specific activity of the human sodium/taurocholate cotransporter SO GENOMICS LA English DT Article ID BILE-ACID COTRANSPORTER; HEPATOCYTE NUCLEAR FACTOR-6; BINDING-PROTEIN ISOFORMS; RNA POLYMERASE-II; RAT-LIVER; GENE-EXPRESSION; TRANSCRIPTION FACTORS; PROMOTER REGION; TAUROCHOLATE TRANSPORT; MOLECULAR-CLONING AB Bile salts are rapidly removed from the circulation by the liver-specific sodium/taurocholate cotransporter (SLC10A1), To understand factors controlling its liver-specific expression, we isolated human SLC10A1 from a YAC chromosomal clone. SLC10A1 spans similar to 23 kb distributed over five exons, The major transcription start site is at 299 bp, and a minor start site is at 395 bp from the translational start site. A 1.2-kb portion of the 5' flanking region was sequenced and shown. to contain a number of liver-enriched elements, but no TATA box. Using secreted alkaline phosphatase reporter constructs liver-specific expression was examined. Transient transfection demonstrated that SLC10A1 promoter expression was selectively expressed eightfold in FAO and rat hepatocytes, while deletion mutants demonstrated liver-specific expression in a region extending from -5 to +198 bp, which contained putative sites for C/EBP and HNF3, Mutations of the C/EBP site resulted in loss of 77% of transcriptional activity. Cotransfection of C/EBP, but not other putative liver-enriched binding factors, increased SLC10A1 promoter activity. Electrophoretic mobility shift assays demonstrated specific protein-DNA interactions that involved C/EBP alpha and beta, These studies demonstrate that the TATA-less human SLC10A1 promoter exhibits liver-specific activity and its regulatory elements contain binding sites for C/EBP, which contributes specifically to its transcriptional regulation, (C) 2000 Academic Press. C1 Univ Colorado, Hlth Sci Ctr, Dept Med B145, Denver, CO 80262 USA. Denver Vet Affiars Med Ctr, Denver, CO 80262 USA. RP Simon, FR (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Med B145, 4200 E 9th Ave, Denver, CO 80262 USA. RI Qadri, Ishtiaq/I-6889-2013 FU NCI NIH HHS [CA46934]; NIDDK NIH HHS [R01 DK-15851] NR 55 TC 20 Z9 20 U1 0 U2 3 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0888-7543 J9 GENOMICS JI Genomics PD OCT 15 PY 2000 VL 69 IS 2 BP 203 EP 213 DI 10.1006/geno.2000.6329 PG 11 WC Biotechnology & Applied Microbiology; Genetics & Heredity SC Biotechnology & Applied Microbiology; Genetics & Heredity GA 368KT UT WOS:000090116700006 PM 11031103 ER PT J AU Larson, VD Williams, DW Henderson, WG Luethke, LE Beck, LB Noffsinger, D Wilson, RH Dobie, RA Haskell, GB Bratt, GW Shanks, JE Stelmachowicz, P Studebaker, GA Boysen, AE Donahue, A Canalis, R Fausti, SA Rappaport, BZ AF Larson, VD Williams, DW Henderson, WG Luethke, LE Beck, LB Noffsinger, D Wilson, RH Dobie, RA Haskell, GB Bratt, GW Shanks, JE Stelmachowicz, P Studebaker, GA Boysen, AE Donahue, A Canalis, R Fausti, SA Rappaport, BZ CA NIDCD VA Hearing Aid Clin Trial Gr TI Efficacy of 3 commonly used hearing aid circuits - A crossover trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID COMPRESSION; IMPAIRMENT; BENEFIT; PERFORMANCE; PROFILE; QUALITY; GAIN; LIFE AB Context Numerous studies have demonstrated that hearing aids provide significant benefit for a wide range of sensorineural hearing loss, but no carefully controlled, multicenter clinical trials comparing hearing aid efficacy have been conducted. Objective To compare the benefits provided to patients with sensorineural hearing loss by 3 commonly used hearing aid circuits. Design Double-blind, 3-period, 3-treatment crossover trial conducted from May 1996 to February 1998. Setting Eight audiology laboratories at Department of Veterans Affairs medical centers across the United States. Patients A sample of 360 patients with bilateral sensorineural hearing loss (mean age, 67.2 years; 57% male, 78.6% white). Intervention Patients were randomly assigned to 1 of 6 sequences of linear peak clipper (PC), compression limiter (CL), and wide dynamic range compressor (WDRC) hearing aid circuits. All patients wore each of the 3 bearing aids, which were installed in identical casements, for 3 months, Main Outcome Measures Results of tests of speech recognition, sound quality, and subjective hearing aid benefit, administered at baseline and after each 3-month intervention with and without a hearing aid. At the end of the experiment, patients ranked the 3 hearing aid circuits. Results Each circuit markedly improved speech recognition, with greater improvement observed for soft and conversationally loud speech (all 52-dB and 62-dB conditions, P less than or equal to .001). All 3 circuits significantly reduced the frequency of problems encountered in verbal communication. Some test results suggested that CL and WDRC circuits provided a significantly better listening experience than PC circuits in word recognition (P = .002), loudness (P = .003), overall liking (P = .001), aversiveness of environmental sounds (P = .02), and distortion (P = .02). In the rank-order ratings, patients preferred the CL hearing aid circuits more frequently (41.6%) than the WDRC (29.8%) and the PC (28.6%) (P = .001 for CL vs both WDRC and PC). Conclusions Each circuit provided significant benefit in quiet and noisy listening situations. The CL and WDRC circuits appeared to provide superior benefits compared with the PC, although the differences between them were much less than the differences between the aided vs unaided conditions. C1 Dept Vet Affairs Med Ctr, Washington, DC USA. Hines VA Cooperat Studies Program, Coordinating Ctr, Hines, IL USA. Natl Inst Deafness & Other Commun Disorders, Bethesda, MD USA. Greater Los Angeles VA Hlth Care Syst, Los Angeles, CA USA. Dept Vet Affairs Med Ctr, Mt Home, TN USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Dept Vet Affairs Med Ctr, Iowa City, IA 52242 USA. Dept Vet Affairs Med Ctr, Nashville, TN 37212 USA. Dept Vet Affairs Med Ctr, Long Beach, CA USA. Boys Town Natl Res Hosp, Omaha, NE 68131 USA. Univ Memphis, Memphis, TN 38152 USA. Univ Calif Los Angeles, Harborview Med Ctr, Los Angeles, CA USA. Dept Vet Affairs Med Ctr, Portland, OR USA. Dept Vet Affairs Med Ctr, Albuquerque, NM USA. RP Larson, VD (reprint author), Howard Leight Ind, 7828 Waterville Rd, San Diego, CA 92154 USA. OI dobie, robert/0000-0003-3833-1772 NR 35 TC 47 Z9 49 U1 2 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD OCT 11 PY 2000 VL 284 IS 14 BP 1806 EP 1813 DI 10.1001/jama.284.14.1806 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 359PW UT WOS:000089622100032 PM 11025833 ER PT J AU Karlawish, JHT Klocinski, JL Merz, J Clark, CM Asch, DA AF Karlawish, JHT Klocinski, JL Merz, J Clark, CM Asch, DA TI Caregivers' preferences for the treatment of patients with Alzheimer's disease SO NEUROLOGY LA English DT Article ID CONTROLLED TRIAL; DECISIONS; DEMENTIA; OUTCOMES; DRUGS; TRANSPLANTATION; RISKS AB Objectives: To learn caregivers' preferences for the treatment of AD with a disease-slowing therapy, and to identify relationships between these preferences and the characteristics of caregivers and patients. Methods: A structured interview with 40 caregivers of patients with AD. Preferences were measured for an AD-slowing medicine with the benefits of a gain in survival and a delay to nursing home placement (NHP), and risks of three degrees of severity of GI bleeding. Results: Using a six-point scale ranging from "not at all important" to "extremely important," the median rating of the importance of survival as a treatment benefit was "very important" and of a delay to NHP was "extremely important." Fifty-five percent of the caregivers identified a benefit more important than these two benefits. Qualitative data showed that caregivers' reasons for these preferences featured the importance of patient quality of life, and the preservation of patient cognition and function. Bivariate analyses showed that increasing importance of the benefit of survival was related to higher assessments of the patient's health and quality of life, and lower ratings of the caregiver's experience of burden. In order to slow disease progression by 1 year, 25/38 (66%) of caregivers would accept some risk of death from gastrointestinal bleeding. Regression models showed that risk tolerance was higher among caregivers who were working, adult children caring for early stage patients or from families with an history of dementia. Conclusions: Caregivers generally are willing to tolerate notable amounts of risk to slow AD progression. Factors that describe the caregiver's experience and perception of the patient and the patient-caregiver relationship influence how they want to treat the disease. This information may be useful for decisions about how to study and prescribe AD treatments. C1 Univ Penn, Inst Aging, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Dept Med, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Dept Sociol, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Dept Mol & Cellular Engn, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Dept Neurol, Philadelphia, PA USA. Univ Penn, Alzheimers Dis Ctr, Philadelphia, PA 19104 USA. Univ Penn, Ctr Bioeth, Philadelphia, PA 19104 USA. RP Karlawish, JHT (reprint author), Univ Penn, Inst Aging, 3615 Chestnut St, Philadelphia, PA 19104 USA. FU NHGRI NIH HHS [R01-HG01765]; NIA NIH HHS [AG-01024, K01-AG00931] NR 36 TC 43 Z9 46 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD OCT 10 PY 2000 VL 55 IS 7 BP 1008 EP 1014 PG 7 WC Clinical Neurology SC Neurosciences & Neurology GA 360ZD UT WOS:000089696500020 PM 11061260 ER PT J AU Mahoney, JE Palta, M Johnson, J Jalaluddin, M Gray, S Park, S Sager, M AF Mahoney, JE Palta, M Johnson, J Jalaluddin, M Gray, S Park, S Sager, M TI Temporal association between hospitalization and rate of falls after discharge SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 51st Annual Scientific Meeting of the Gerontological-Society-of-America CY NOV 20-24, 1998 CL PHILADELPHIA, PENNSYLVANIA SP Gerontol Soc Amer ID ELDERLY PATIENTS; BED REST; RISK-FACTORS; DELIRIUM; COMMUNITY; HOME; POPULATION; PREDICTORS; ILLNESS; PEOPLE AB Background: Evidence suggests that acute illness and hospitalization may increase the risk for falls. Objective: To evaluate the rate of falls, and associated risk factors, for 90 days following hospital discharge. Methods: We consecutively enrolled 311 patients, aged 65 years and older, discharged from the hospital after an acute medical illness and receiving home-nursing services. Patients were assessed within 5 days of discharge for prehospital and current functioning by self-report, and balance, vision, cognition, and delirium by objective measures. Patients were followed up weekly for 13 weeks for falls, injuries, and health care use. Results: The rate of falls was significantly higher in the first 2 weeks after hospitalization (8.0 per 1000 person-days) compared with 3 months later (1.7 per 1000 person-days) (P=.002). Fall-related injuries accounted for 15% of all hospitalizations in the first month after discharge. Independent prehospital risk factors significantly associated with falls included dependency in activities of daily living, use of a standard walker, 2 or more falls, and more hospitalizations in the year prior. Posthospital risk factors included use of a tertiary amine tricyclic antidepressant, probable delirium, and poorer balance, while use of a cane was protective. Conclusions: The rate of falls is substantially increased in the first month after medical hospitalization, and is an important cause of injury and morbidity. Posthospital risk factors may be potentially modifiable. Efforts to assess and modify risk factors should be integral to the hospital and posthospital care of older adults (those aged greater than or equal to 65 years). C1 Univ Wisconsin, Sch Med, Dept Med, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Dept Prevent Med, Madison, WI USA. William S Middleton Mem Vet Hosp, Ctr Geriatr Res Educ & Clin, Madison, WI USA. Univ Wisconsin, Dept Biostat & Med Informat, Madison, WI USA. New England Ctr Integrat Hlth, Lyme, NH USA. SmithKline Beecham Pharmaceut, Philadelphia, PA USA. Univ Washington, Sch Pharm, Seattle, WA 98195 USA. RP Mahoney, JE (reprint author), Univ Wisconsin, Sch Med, Dept Med, 2870 Univ Ave,Suite 100, Madison, WI 53705 USA. FU NIA NIH HHS [K08AG00623, K08AG00808-01] NR 47 TC 55 Z9 58 U1 2 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD OCT 9 PY 2000 VL 160 IS 18 BP 2788 EP 2795 DI 10.1001/archinte.160.18.2788 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 357XQ UT WOS:000089527600010 PM 11025789 ER PT J AU Mao, CG Xu, RJ Bielawska, A Szulc, ZM Obeid, LM AF Mao, CG Xu, RJ Bielawska, A Szulc, ZM Obeid, LM TI Cloning and characterization of a Saccharomyces cerevisiae alkaline ceramidase with specificity for dihydroceramide SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID STRESS-RESPONSE; SPHINGOLIPIDS; IDENTIFICATION; PROLIFERATION; METABOLISM; GROWTH AB In a previous study, we reported that the Saccharomyces cerevisiae gene YPC1 encodes an alkaline ceramidase with a dual activity, catalyzing both hydrolysis and synthesis of yeast ceramide (Mao, C., Xu, R., Bielawska, A., and Obeid, L., M., (2000) J. Biol. Chem. 275, 6876-6884). In this study, we have identified a YPC1 homologue in S. cerevisiae that also encodes an alkaline ceramidase, We show that these two ceramidases have different substrate specificity, such that YPC1p preferentially hydrolyzes phytoceramide, whereas the new ceramidase YDC1p hydrolyzes dihydroceramide preferentially and phytoceramide only slightly. Neither enzyme hydrolyzes unsaturated mammalian-type ceramide. In contrast to YPC1p, YDC1p had only minor in vitro reverse activity of catalyzing dihydroceramide formation from a free fatty acid and dihydrosphingosine and no activity with phytosphingosine, Overexpression of YDC1p had no reverse activity in non-stressed yeast cells, but like YPC1p suppressed the inhibition of growth by fumonisin B1 albeit more modestly. Deletion of YDC1 and YPC1 or both did not apparently affect growth, suggesting neither gene is essential, However, the Delta ydc1 deletion mutant but not the Delta ypc1 deletion mutant was sensitive to heat stress, indicating a role for dihydroceramide but not phytoceramide in heat stress responses, and suggesting that the two enzymes have distinct physiological functions. C1 Ralph H Johnson Vet Affairs Hosp, Div Gen Internal Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem, Charleston, SC 29425 USA. RP Obeid, LM (reprint author), Ralph H Johnson Vet Affairs Hosp, Div Gen Internal Med, 114 Doughty St,Rm 604 STB,POB 250779, Charleston, SC 29425 USA. OI obeid, lina/0000-0002-0734-0847 FU NIA NIH HHS [AG12467, AG16583] NR 28 TC 103 Z9 106 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD OCT 6 PY 2000 VL 275 IS 40 BP 31369 EP 31378 DI 10.1074/jbc.M003683200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 362DE UT WOS:000089762700088 PM 10900202 ER PT J AU McLellan, AT Lewis, DC O'Brien, CP Kleber, HD AF McLellan, AT Lewis, DC O'Brien, CP Kleber, HD TI Drug dependence, a chronic medical illness - Implications for treatment, insurance, and outcomes evaluation SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID CEREBRAL BLOOD-FLOW; OUT-OF-TREATMENT; DSM-III-R; FOLLOW-UP; ALCOHOL DEPENDENCE; COCAINE ABUSERS; DIABETES-MELLITUS; FEMALE TWINS; BRAIN; CARE AB The effects of drug dependence on social systems has helped shape the generally held view that drug dependence is primarily a social problem, not a health problem. In turn, medical approaches to prevention and treatment are lacking, We examined evidence that drug (including alcohol) dependence is a chronic medical illness. A literature review compared the diagnoses, heritability, etiology (genetic and environmental factors), pathophysiology, and response to treatments (adherence and relapse) of drug dependence vs type 2 diabetes mellitus, hypertension, and asthma, Genetic heritability, personal choice, and environmental factors are comparably involved in the etiology and course of all of these disorders. Drug dependence produces significant and lasting changes in brain chemistry and function. Effective medications are available for treating nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence, Medication adherence and relapse rates are similar across these illnesses. Drug dependence generally has been treated as if it were an acute illness, Review results suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits. Drug dependence should be insured, treated, and evaluated like other chronic illnesses. C1 Treatment Res Inst, Philadelphia, PA 19106 USA. Vet Affairs Med Ctr, Penn VA Ctr Studies Addict, Philadelphia, PA USA. Univ Penn, Philadelphia, PA 19104 USA. Brown Univ, Ctr Alcohol & Addict Studies, Providence, RI 02912 USA. Columbia Univ, Natl Ctr Addict & Subst Abuse, New York, NY USA. RP McLellan, AT (reprint author), Treatment Res Inst, 150 S Independence Mall W,Suite 600, Philadelphia, PA 19106 USA. NR 91 TC 988 Z9 1005 U1 20 U2 144 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD OCT 4 PY 2000 VL 284 IS 13 BP 1689 EP 1695 DI 10.1001/jama.284.13.1689 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 357KY UT WOS:000089501900030 PM 11015800 ER PT J AU Palevsky, PM Washington, MS Stevenson, JA Rohay, JM Dyer, NJ Lockett, R Perry, SB AF Palevsky, PM Washington, MS Stevenson, JA Rohay, JM Dyer, NJ Lockett, R Perry, SB TI Improving compliance with the dialysis prescription as a strategy to increase the delivered dose of hemodialysis: An ESRD Network 4 quality improvement project SO ADVANCES IN RENAL REPLACEMENT THERAPY LA English DT Article DE hemodialysis; ESRD; adequacy of dialysis; quality improvement ID UNITED-STATES; PREDICTORS; MORTALITY; SURVIVAL; ADEQUACY AB Delivery of an inadequate dose of hemodialysis is associated with a significant increase in the relative risk of both hospitalization and death. We hypothesized that noncompliance with the dialysis prescription, defined as failure to achieve the prescribed blood flow, failure to dialyze for the prescribed duration, or failure to use the prescribed dialyzer, was a significant factor in patients not achieving a urea reduction ratio (URR) of greater than or equal to0.65. We identified the 29 dialysis facilities in ESRD Network 4 that had the lowest average URR and/or lowest percent of patients with a URR greater than or equal to0.65 based on quarterly data reports. Each facility was surveyed by review of all dialysis treatment sheets from a single week by network staff to evaluate for noncompliance with the dialysis prescription. Facility-specific data were reported back to each facility. Each facility was required to develop a facility-specific quality improvement plan after receiving intensive education on the quality improvement process. After 9 months the facilities were resurveyed. Although the compliance with the dialysis prescription decreased from 54.0% to 53.6% (P = .026), the delivered URR increased from 0.679 +/- 0.072 to 0.688 +/- 0.070 (P = .026) with an increase in the percentage of patients with a URR greater than or equal to0.65 from 69.7% to 75% (P = .0096). Kt/V increased from 1.37 +/- 0.26 to 1.41 +/- 0.27 (P = .0001). Analysis of the process changes instituted by the individual facilities showed an increase in the prescribed dose of dialysis. Thus, although the process goal of improved compliance with the dialysis prescription was not achieved, the outcome goal of an increased delivered dose of dialysis was met through an alternative process change of an augmented dialysis prescription. (C) 2000 by the National Kidney Foundation, Inc. C1 ESRD Network 4, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Palevsky, PM (reprint author), ESRD Network 4, 200 Lothrop St, Pittsburgh, PA 15213 USA. FU PHS HHS [500-97-E022] NR 17 TC 9 Z9 9 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1073-4449 J9 ADV RENAL REPLACE TH JI Adv. Renal Replace. Ther. PD OCT PY 2000 VL 7 IS 4 SU 1 BP S21 EP S30 DI 10.1053/jarr.2000.18429 PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 368JD UT WOS:000090113100004 PM 11053583 ER PT J AU Palevsky, PM Washington, MS Stevenson, JA Rohay, JM Dyer, NJ Lockett, R Perry, SB AF Palevsky, PM Washington, MS Stevenson, JA Rohay, JM Dyer, NJ Lockett, R Perry, SB TI Barriers to the delivery of adequate hemodialysis in ESRD Network 4 SO ADVANCES IN RENAL REPLACEMENT THERAPY LA English DT Article DE hemodialysis; ESRD; adequacy of dialysis ID UNITED-STATES; DIALYSIS; PRESCRIPTION; PREDICTORS; SURVIVAL AB Dialysis dose has been established as a determinant of morbidity and mortality in chronic hemodialysis patients. To identify remediable barriers to the delivery of adequate hemodialysis, we examined factors that affected adherence to prescribed dialysis dose. End-Stage Renal Disease (ESRD) Network 4 facilities that fell into the lowest quintile in measures of dialysis adequacy were studied. At the time of this study, Network 4 was composed of 178 dialysis facilities in Delaware and Pennsylvania. Those 29 facilities had an average delivered urea reduction ratio (URR) of <0.67 and/or 71% of patients with a URR of 0.65. (The mean URR value of Network 4 was 0.699 with a compliance ratio of 80%.) Dialysis treatment sheets were reviewed for all patients in the 29 facilities for all treatments during a calendar week. Predialysis and postdialysis blood urea nitrogen (BUN) values from 1 treatment during this week were used to calculate URR and Kt/V. A total of 1,339 patients with a mean age of 61.9 15.1 years and a mean duration of ESRD of 3.4 +/- 3.3 years were dialyzed in the 29 units. Mean prescribed duration of dialysis (T) was 219 +/- 26 min. with a mean blood flow rate (BFR) of 393 +/- 62 mL/min. Concordance between the prescribed and delivered T (-5 min), DFP (-50 mL/min), and hemodialyzer were assessed, by patient, for each treatment (Tx). Characteristics of a delivered Kt/V 4 < 1.2 were duration <4 hours, BFR < 350 mL/min, patient weight > 100 kg, and delivered BFR 50 mL/min less than prescribed BFR. Multivariate analysis of the relationship between delivered dose of dialysis and patients and treatment characteristics identified black race, male gender, and younger age as demographic factors associated with low delivered dose. potential remediable barriers identified by this analysis included reduced treatment time (>10%) and use of catheters for angioaccess. These data suggest components of the dialysis process that might be targeted in future quality improvement projects to improve the adequacy of dialysis delivery. (C) 2000 by the National Kidney Foundation, Inc. C1 ESRD Network 4, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Palevsky, PM (reprint author), ESRD Network 4, 200 Lothrop St, Pittsburgh, PA 15213 USA. FU PHS HHS [500-97-E022] NR 15 TC 12 Z9 12 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1073-4449 J9 ADV RENAL REPLACE TH JI Adv. Renal Replace. Ther. PD OCT PY 2000 VL 7 IS 4 SU 1 BP S11 EP S20 DI 10.1053/jarr/2000.18428 PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 368JD UT WOS:000090113100003 PM 11053582 ER PT J AU Gliatto, MF AF Gliatto, MF TI Generalized anxiety disorder (Reprinted from Diagnostic and statistical manual of mental disorders, pg 435-6, 1994) SO AMERICAN FAMILY PHYSICIAN LA English DT Reprint ID COGNITIVE-BEHAVIOR-THERAPY; CHRONIC MEDICAL CONDITIONS; PRIMARY-CARE; TREATMENT ALGORITHM; PANIC DISORDER; MANAGEMENT; DIAZEPAM; PLACEBO; KAVA; BENZODIAZEPINES AB Patients with generalized anxiety disorder experience worry or anxiety and a number of physical and psychologic symptoms. The disorder is frequently difficult to diagnose because of the variety of presentations and the common occurrence of comorbid medical or psychiatric conditions. The lifetime prevalence is approximately 4 to 6 percent in the general population and is more common in women than in men. It is often chronic, and patients with this disorder are more likely to be seen by family physicians than by psychiatrists. Treatment consists of pharmacotherapy and various forms of psychotherapy. The benzodiazepines are used for short-term treatment, but because of the frequently chronic nature of generalized anxiety disorder, they may need to be continued for months to years. Buspirone and antidepressants are also used for the pharmacologic management of patients with generalized anxiety disorder. Patients must receive an appropriate pharmacologic trial with dosage titrated to optimal levels as judged by the control of symptoms and the tolerance of side effects. Psychiatric consultation should be considered for patients who do not respond to an appropriate trial of pharmacotherapy. C1 Philadelphia Vet Affairs Med Ctr, Dept Psychiat, Philadelphia, PA 19104 USA. RP Gliatto, MF (reprint author), Philadelphia Vet Affairs Med Ctr, Dept Psychiat, 38th & Woodland Ave, Philadelphia, PA 19104 USA. NR 40 TC 13 Z9 13 U1 0 U2 2 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD OCT 1 PY 2000 VL 62 IS 7 BP 1591 EP 1600 PG 10 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 362CX UT WOS:000089762000009 PM 11037076 ER PT J AU Selby, DM Kohlmeier, RE Cho, CG Bux, R Gulley, ML AF Selby, DM Kohlmeier, RE Cho, CG Bux, R Gulley, ML TI Prothrombin gene mutation is uncommon in victims of fatal pulmonary embolism. SO AMERICAN JOURNAL OF CLINICAL PATHOLOGY LA English DT Meeting Abstract C1 Wilford Hall USAF Med Ctr, San Antonio, TX 78236 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Bexar Cty Forens Sci Ctr, San Antonio, TX USA. Audie L Murphy Mem Vet Hosp, San Antonio, TX 78284 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC CLIN PATHOLOGISTS PI CHICAGO PA 2100 W HARRISON ST, CHICAGO, IL 60612 USA SN 0002-9173 J9 AM J CLIN PATHOL JI Am. J. Clin. Pathol. PD OCT PY 2000 VL 114 IS 4 MA 77 BP 654 EP 655 PG 2 WC Pathology SC Pathology GA 357ZX UT WOS:000089533700089 ER PT J AU Ofman, JJ Lewin, K Ramers, C Ippoliti, A Lieberman, D Weinstein, W AF Ofman, JJ Lewin, K Ramers, C Ippoliti, A Lieberman, D Weinstein, W TI The economic impact of the diagnosis of dysplasia in Barrett's esophagus SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID HIGH-GRADE DYSPLASIA; EARLY ADENOCARCINOMA; ENDOSCOPIC BIOPSY; SURVEILLANCE; DISEASE AB OBJECTIVE: Cost-effective strategies for identifying patients with Barrett's esophagus who are most likely to develop cancer have not been developed. Surveillance endoscopy is currently used, and we hypothesized that more frequent surveillance intervals would identify patients with "transient positive" diagnoses of dysplasia-dysplasia found on one examination but not on subsequent ones. Our aim was to explore the potential economic impact of transient positive diagnoses of dysplasia on alternative surveillance strategies over a IO-yr period. METHODS: Data were derived from a 2-yr randomized, prospective study comparing omeprazole to ranitidine in 95 patients with Barrett's esophagus. A transient positive diagnosis of dysplasia was defined as a patient who was diagnosed with dysplasia during the study period but whose 24-month biopsies revealed no dysplasia. We calculated the number of transient positive diagnoses of dysplasia and modeled the potential economic impact of a diagnosis of dysplasia over a 10-yr period. RESULTS: Thirty patients (31%) had at least one reading of dysplasia during the study period. Nineteen patients (20%) had a transient positive diagnosis of dysplasia. During the study period, no cancers were found. A surveillance strategy of every other year and every 6 months for dysplasia would result in 1072 endoscopies over a 10-yr period at a discounted cost of $1,587,184. A total of 61% of endoscopies would be because of transient positive diagnoses of dysplasia. A strategy of yearly surveillance and every 6 months for dysplasia would result in 1404 endoscopies at a discounted cost of $2,096,733, of which 28% would result from transient positive diagnoses of dysplasia. The discounted incremental costs of more frequent surveillance in this cohort of patients over 10 yr is $509,549. CONCLUSIONS: Based on current practice strategies, transient positive diagnoses of dysplasia account for 28-61% of endoscopies in Barrett's surveillance programs. This analysis suggests that the endoscopy workload and costs associated with surveillance could be substantially reduced if patients with transient positive diagnoses of dysplasia reverted to usual surveillance after two negative examinations. (Am J Gastroenterol 2000;95:2946-2952. (C) 2000 by Am. Coll. of Gastroenterology). C1 Cedars Sinai Hlth Syst, Dept Med, Los Angeles, CA USA. Cedars Sinai Hlth Syst, Dept Hlth Serv Res, Los Angeles, CA USA. Zynx Hlth Inc, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Pathol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, CURE, Los Angeles, CA 90024 USA. Portland Vet Affairs Med Ctr, Dept Med, Portland, OR USA. RP Ofman, JJ (reprint author), 9100 Wishire Blvd,Suite 655 E, Beverly Hills, CA 90212 USA. NR 21 TC 24 Z9 24 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD OCT PY 2000 VL 95 IS 10 BP 2946 EP 2952 DI 10.1016/S0002-9270(00)02002-5 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 364JC UT WOS:000089888400042 PM 11051373 ER PT J AU Fernandez, MJ Raskind, WH Wolff, J Matsushita, M Lipe, H Bird, TD AF Fernandez, MJ Raskind, WH Wolff, J Matsushita, M Lipe, H Bird, TD TI Benign hereditary chorea with suggestive linkage to 14q: confirmation of a diagnostic entity and narrowing the critical region. SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Meeting Abstract C1 Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat, Seattle, WA USA. Geriatr Res Serv, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0002-9297 J9 AM J HUM GENET JI Am. J. Hum. Genet. PD OCT PY 2000 VL 67 IS 4 SU 2 MA 1664 BP 302 EP 302 PG 1 WC Genetics & Heredity SC Genetics & Heredity GA 355TA UT WOS:000089400701665 ER PT J AU Sugimoto, Y Morita, R Amano, K Fong, CYG Shah, PU Castroviejo, IP Khan, S Delgado-Escueta, AV Yamakawa, K AF Sugimoto, Y Morita, R Amano, K Fong, CYG Shah, PU Castroviejo, IP Khan, S Delgado-Escueta, AV Yamakawa, K TI Childhood absence epilepsy in 8q24: Refinement of candidate region and construction of physical map. SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Meeting Abstract C1 RIKEN, Brain Sci Inst, Neurogenet Lab, Wako, Saitama, Japan. Univ Calif Los Angeles, Sch Med, Epilepsy Genom Lab, Comprehensive Epilepsy Program, Los Angeles, CA USA. W Los Angeles DVA Med Ctr, Los Angeles, CA USA. Univ Hosp La Paz, Madrid, Spain. Riyadh Armed Forces Hosp, Dept Neurosci, Riyadh, Saudi Arabia. RI Yamakawa, Kazuhiro/N-5050-2015 NR 0 TC 0 Z9 0 U1 0 U2 0 PU CELL PRESS PI CAMBRIDGE PA 600 TECHNOLOGY SQUARE, 5TH FLOOR, CAMBRIDGE, MA 02139 USA SN 0002-9297 EI 1537-6605 J9 AM J HUM GENET JI Am. J. Hum. Genet. PD OCT PY 2000 VL 67 IS 4 SU 2 MA 1669 BP 302 EP 302 PG 1 WC Genetics & Heredity SC Genetics & Heredity GA 355TA UT WOS:000089400701670 ER PT J AU Zareparsi, S Kaye, J Camicioli, R Gancher, S Nutt, J Payami, H AF Zareparsi, S Kaye, J Camicioli, R Gancher, S Nutt, J Payami, H TI Genetic analysis of onset age of Parkinson's disease: Apolipoprotein E. SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Meeting Abstract C1 Oregon Hlth Sci Univ, Dept Neurol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. Kaiser Permanente, Portland, OR USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0002-9297 J9 AM J HUM GENET JI Am. J. Hum. Genet. PD OCT PY 2000 VL 67 IS 4 SU 2 MA 1900 BP 341 EP 341 PG 1 WC Genetics & Heredity SC Genetics & Heredity GA 355TA UT WOS:000089400701899 ER PT J AU Wong, CS Gipson, DS Gillen, DL Emerson, S Koepsell, T Sherrard, DJ Watkins, SL Stehman-Breen, C AF Wong, CS Gipson, DS Gillen, DL Emerson, S Koepsell, T Sherrard, DJ Watkins, SL Stehman-Breen, C TI Anthropometric measures and risk of death in children with end-stage renal disease SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article; Proceedings Paper CT 32nd Annual Meeting of the American-Society-of-Nephrology CY NOV 01-08, 1999 CL MIAMI, FLORIDA SP Amer Soc Nephrol DE pediatric; growth; body mass index (BMI); survival ID GROWTH-FACTOR-I; CHRONIC PERITONEAL-DIALYSIS; HEMODIALYSIS-PATIENTS; IGF-I; DILATED CARDIOMYOPATHY; TRANSPLANT RECIPIENTS; KIDNEY-TRANSPLANT; HORMONE TREATMENT; MORTALITY; FAILURE AB We evaluated the association between anthropometric measurements and death among pediatric patients with end-stage renal disease (ESRD) using data from the Pediatric Growth and Development Special Study (PGDSS) from the US Renal Data System. Height, growth velocity, and body mass index (BMI) were used for the analysis of 1,949 patients in the PGDSS. To standardize these measurements, SD scores (SDSs) were calculated using population data from the Third National Health and Nutrition Examination Survey. Using Cox proportional hazards models, we assessed the association between anthropometric measures and death, controlling for demographic factors and stratifying by age. Multivariate analysis showed that each decrease by 1 SDS in height was associated with a 14% increase in risk for death (adjusted relative risk [aRR], 1.14; 95% confidence interval [CI], 1.02 to 1.27; P = 0.017). For each 1 SDS decrease in growth velocity among patients in our sample, the risk for death increased by 12% (aRR, 1.12; 95% CI, 1.00 to 1.25; P = 0.043). There was a statistically significant ill-shaped association between BMI and death (P = 0.001), with relatively low and high BMIs associated with an increased risk for death. In children with ESRD, growth delay and extremes in BMI are associated with an increased risk for mortality. (C) 2000 by the National Kidney Foundation, Inc. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Childrens Hosp & Reg Med Ctr, Div Nephrol, Seattle, WA 98108 USA. Univ Washington, Sch Publ Hlth & Community Med, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth & Community Med, Dept Epidemiol, Seattle, WA 98195 USA. Univ N Carolina, Sch Med, Div Nephrol, Chapel Hill, NC 27599 USA. RP Stehman-Breen, C (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [TDK 07662-08] NR 55 TC 96 Z9 103 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD OCT PY 2000 VL 36 IS 4 BP 811 EP 819 DI 10.1053/ajkd.2000.17674 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 358HJ UT WOS:000089552300020 PM 11007685 ER PT J AU Getchell, WS Larsen, GC Morris, CD McAnulty, JH AF Getchell, WS Larsen, GC Morris, CD McAnulty, JH TI A comparison of medicare fee-for-service and a group-model HMO in the inpatient management and long-term survival of elderly individuals with syncope SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID HEALTH MAINTENANCE ORGANIZATION; HOSPITALIZED-PATIENTS; DIAGNOSING SYNCOPE; CHRONICALLY ILL; PRIMARY-CARE; OUTCOMES; MORTALITY; SPECIALTY; INSURANCE; IMPACT AB Objective: To compare the management and survival of elderly patients hospitalized with syncope in 2 healthcare delivery systems. Study Design: Retrospective cohort. Patients and Methods: Using hospitalization records from Medicare and a group-model health maintenance organization (HMO) in Oregon, we identified individuals with an admission or discharge diagnosis of syncope between 1992 and 1994, Among patients 65 years or older (median age = 79 years), we randomly selected a sample of the standard Medicare patients (primarily fee-for-service; n = 473) and all of the group-model HMO patients (n = 583). Use of inpatient testing and consultation was ascertained by chart review; all-cause mortality was obtained from the National Death Index. Results: Median diagnostic testing and consultation costs were the same (P = .35) in the standard Medicare population ($643) and the HMO population ($619), although the use of specific tests differed. More cardiovascular syncope was identified in the Medicare population (23% vs 18%; P = .02). Inpatient, 30-day, 1-year, and 4-year mortality rates were higher in the Medicare population (1.7%, 3.8%, 16.7%, and 50.6% respectively) than in the HMO population (0.7%, 1.5 %, 13.2%, and 41.8%). After adjusting for age, gender, comorbidity, diagnostic testing, and administrative factors, the relative risk (RR) of dying was lower for group-model HMO patients (RR = 0.74; 95% confidence interval = 0.60, 0.91) than for standard Medicare patients (RR = 1.0). Conclusions: The inpatient management of these elderly patients with syncope was similar in the group-model HMO and standard Medicare settings, but survival was better for the individuals in the HMO. The reason for the differential survival is not obvious and warrants additional study. C1 Portland Vet Affairs Med Ctr, Cardiol Sect, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Dept Publ Hlth & Prevent Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Cardiol, Dept Med, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Cardiol, Div Med Informat & Outcomes Res, Portland, OR 97201 USA. RP Getchell, WS (reprint author), Portland Vet Affairs Med Ctr, Cardiol Sect, P3-CARD,3710 SW US Vet Hosp Dr, Portland, OR 97207 USA. FU AHRQ HHS [T32 HS00069] NR 39 TC 3 Z9 3 U1 1 U2 1 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD OCT PY 2000 VL 6 IS 10 BP 1089 EP 1098 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 365EK UT WOS:000089935300001 PM 11184665 ER PT J AU Good, CB Fultz, SL Trilli, L Etchason, J AF Good, CB Fultz, SL Trilli, L Etchason, J TI Therapeutic substitution of cimetidine for nizatidine was not associated with an increase in healthcare utilization SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID H-2-RECEPTOR ANTAGONISTS; CLINICAL DIFFERENCES; DRUGS; COSTS AB Objective: To examine changes in healthcare utilization resulting from a formulary switch to cimetidine from nizatidine at the Veterans Affairs Pittsburgh Healthcare System, Study Design: A retrospective analysis of administrative and clinical data 6 months before and 6 months after the therapeutic substitution, Methods: The 704 patients who were switched from nizatidine to cimetidine were included in the study. Administrative data included total and primary care clinic visits, emergency room visits, gastrointestinal (CI)-related radiological studies, and CI endoscopic procedures, Discharge summaries were examined, and rates of total and CI-related hospitalizations were calculated, Results: There was no evidence of increased utilization of healthcare resources during the 6 months after the formulary switch. Estimated monthly pharmaceutical savings for the Veterans Affairs Pittsburgh Healthcare System were $7260, Conclusions: A formulary switch from nizatidine to cimetidine can be accomplished at significant pharmaceutical cost savings, and this retrospective study suggests that this can be done without increasing other aspects of healthcare resource utilization. C1 Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Div Gen Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Pharm, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr, Dept Med, Pittsburgh, PA USA. Kerr L White Inst Hlth Serv Res, Atlanta, GA USA. RP Good, CB (reprint author), Vet Affairs Pittsburgh Healthcare Syst, Univ Dr C, Pittsburgh, PA 15240 USA. NR 16 TC 4 Z9 4 U1 1 U2 1 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD OCT PY 2000 VL 6 IS 10 BP 1141 EP 1146 PG 6 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 365EK UT WOS:000089935300005 PM 11184669 ER PT J AU Siegel, RE AF Siegel, RE TI How long a stay in the hospital is needed for patients with community-acquired pneumonia? SO AMERICAN JOURNAL OF MEDICINE LA English DT Editorial Material ID LOW-RISK PATIENTS; ANTIMICROBIAL THERAPY; MEDICAL OUTCOMES; ELDERLY PATIENTS; ANTIBIOTICS; DISCHARGE; CARE C1 Bronx Vet Affairs Med Ctr, Intens Care Unit, Crit Care Ctr, Bronx, NY 10468 USA. Mt Sinai Sch Med, New York, NY USA. RP Siegel, RE (reprint author), Bronx Vet Affairs Med Ctr, Intens Care Unit, Crit Care Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. NR 15 TC 6 Z9 7 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD OCT 1 PY 2000 VL 109 IS 5 BP 434 EP 436 DI 10.1016/S0002-9343(00)00525-8 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 360QE UT WOS:000089678100013 PM 11020402 ER PT J AU Zhang, BX Yeh, CK Hymer, TK Lifschitz, MD Katz, MS AF Zhang, BX Yeh, CK Hymer, TK Lifschitz, MD Katz, MS TI EGF inhibits muscarinic receptor-mediated calcium signaling in a human salivary cell line SO AMERICAN JOURNAL OF PHYSIOLOGY-CELL PHYSIOLOGY LA English DT Article DE carbachol; signal transduction; protein kinase C; mitogen-activated protein kinase; epidermal growth factor ID PROTEIN-KINASE-C; EPIDERMAL GROWTH-FACTOR; INOSITOL TRISPHOSPHATE RECEPTOR; INTRACELLULAR CALCIUM; ACINAR-CELLS; CA2+ ENTRY; ACTIVATION; PHOSPHORYLATION; STIMULATION; EXPRESSION AB The effects of epidermal growth factor (EGF) on intracellular calcium ([Ca2+](i)) responses to the muscarinic agonist carbachol were studied in a human salivary cell line (HSY). Carbachol (10(-4) M)-stimulated [Ca2+](i) mobilization was inhibited by 40% after 48-h treatment with 5 X 10(-10) M EGF. EGF also reduced carbachol-induced [Ca2+](i) in Ca2+-free medium and Ca2+ influx following repletion of extracellular Ca2+. Under Ca2+-free conditions, thapsigargin, an inhibitor of Ca2+ uptake to internal stores, induced similar [Ca2+](i) signals in control and EGF-treated cells, indicating that internal Ca2+ stores were unaffected by EGF; however, in cells exposed to thapsigargin, Ca2+ influx following Ca2+ repletion was reduced by EGF. Muscarinic receptor density, assessed by binding of the muscarinic receptor antagonist L-[benzilic-4,4'-(HCN)-H-3]quinuclidinyl benzilate ([H-3]QNB), was decreased by 20% after EGF treatment. Inhibition of the carbachol response by EGF was not altered by phorbol ester-induced downregulation of protein kinase C (PKC) but was enhanced upon PKC activation by a diacylglycerol analog. Phosphorylation of mitogen-activated protein kinase (MAP kinase) and inhibition of the carbachol response by EGF were both blocked by the MAP kinase pathway inhibitor PD-98059. The results suggest that EGF decreases carbachol-induced Ca2+ release from internal stores and also exerts a direct inhibitory action on Ca2+ influx. A decline in muscarinic receptor density may contribute to EGF inhibition of carbachol responsiveness. The inhibitory effect of EGF is mediated by the MAP kinase pathway and is potentiated by a distinct modulatory cascade involving activation of PKC. EGF may play a physiological role in regulating muscarinic receptor-stimulated salivary secretion. C1 S Texas Vet Hlth Care Syst, Audie L Murphy Div, Geriatr Res Educ & Clin Ctr 182, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Med Res Serv, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. RP Katz, MS (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Div, Geriatr Res Educ & Clin Ctr 182, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. FU NIDCR NIH HHS [DE10756] NR 45 TC 7 Z9 7 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6143 J9 AM J PHYSIOL-CELL PH JI Am. J. Physiol.-Cell Physiol. PD OCT PY 2000 VL 279 IS 4 BP C1024 EP C1033 PG 10 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 356YR UT WOS:000089472200016 PM 11003583 ER PT J AU Zaninovic, V Gukovskaya, AS Gukovsky, I Mouria, M Pandol, SJ AF Zaninovic, V Gukovskaya, AS Gukovsky, I Mouria, M Pandol, SJ TI Cerulein upregulates ICAM-1 in pancreatic acinar cells, which mediates neutrophil adhesion to these cells SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE intercellular adhesion molecule-1; cholecystokinin; nuclear; factor-kappa B; inflammatory response; pancreatitis ID NF-KAPPA-B; CYTOKINE-INDUCED EXPRESSION; NECROSIS-FACTOR-ALPHA; MOLECULE-1 ICAM-1; NECROTIZING PANCREATITIS; TRANSCRIPTION FACTORS; REGULATORY ELEMENTS; EPITHELIAL-CELL; GENE-EXPRESSION; CYTOSKELETON AB Neutrophil infiltration into the pancreas is a key event in pancreatitis. Here we show that intercellular adhesion molecule-1 (ICAM-1), which regulates neutrophil adhesion, is present on rat pancreatic acinar cells, is upregulated by a hormone (cerulein) and mediates direct binding of neutrophils to acinar cells. ICAM-1 was upregulated in pancreas of rats with experimental pancreatitis induced by supramaximal doses of cerulein. Furthermore, cerulein time and dose dependently stimulated expression of ICAM-1 mRNA and protein in isolated pancreatic acinar cells. Inhibitory analysis showed that activation of transcription factor nuclear factor-kappa B (NF-kappa B) was involved in ICAM-1 upregulation by cerulein, but NF-kappa B did not mediate basal expression of ICAM-1 mRNA in acinar cells. With an adhesion assay, we found that neutrophils bind to isolated pancreatic acinar cells and that cerulein upregulates the extent of adhesion. Neutralizing ICAM-1 antibody blocked neutrophil binding to both control and cerulein-stimulated acinar cells, suggesting ICAM-1 involvement in this adhesion. Thus the acinar cell is capable of targeting neutrophils to its surface, a process that may be important for inflammatory and cell death responses in pancreatitis and other pancreatic disorders. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90073 USA. RP Gukovskaya, AS (reprint author), W Los Angeles Vet Affairs Med Ctr, Bldg 258,Rm 340,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM agukovsk@ucla.edu NR 46 TC 60 Z9 62 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD OCT PY 2000 VL 279 IS 4 BP G666 EP G676 PG 11 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 358CG UT WOS:000089539200003 PM 11005752 ER PT J AU Tian, W Zhang, Z Cohen, DM AF Tian, W Zhang, Z Cohen, DM TI MAPK signaling and the kidney SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Review DE urea; tubule; mesangial; extracellular signal-regulated kinase; stress-activated protein kinase; c-Jun NH(2) -terminal kinase; p38; mitogen-activated protein kinase ID ACTIVATED PROTEIN-KINASE; RAT MESANGIAL CELLS; JUN NH2-TERMINAL KINASE; N-TERMINAL KINASE; GLOMERULAR EPITHELIAL-CELLS; CYTOSOLIC PHOSPHOLIPASE A(2); PROMOTES CELLULAR GROWTH; LOW-DENSITY-LIPOPROTEIN; HIGH GLUCOSE CONDITIONS; PROXIMAL TUBULAR CELLS AB Following an overview of the biochemistry of mitogen-activated protein kinase (MAPK) pathways, the relevance of these signaling events to specific models of renal cell function and pathophysiology, both in vitro and in vivo, will be emphasized. In in vitro model systems, events activating the principal MAPK families [extracellular signal-regulated and c-Jun NH(2)-terminal kinase and p38] have been best characterized in mesangial and tubular epithelial cell culture systems and include peptide mitogens, cytokines, lipid mediators, and physical stressors. Several in vivo models of proliferative or toxic renal injury are also associated with aberrant MAPK regulation. It is anticipated that elucidation of downstream effector signaling mechanisms and a clearer understanding of the immediate and remote upstream activating pathways, when applied to these highly clinically relevant model systems, will ultimately provide much greater insight into the basis for specificity now seemingly absent from these signaling events. C1 Oregon Hlth Sci Univ, Div Nephrol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Mol Med, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. RP Cohen, DM (reprint author), Oregon Hlth Sci Univ, Div Nephrol, Portland, OR 97201 USA. EM cohend@ohsu.edu RI Zhang, Zheng/J-2388-2014 OI Zhang, Zheng/0000-0003-2497-0362 FU NIDDK NIH HHS [DK52494] NR 173 TC 111 Z9 130 U1 0 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD OCT PY 2000 VL 279 IS 4 BP F593 EP F604 PG 12 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 356EF UT WOS:000089430800001 PM 10997909 ER PT J AU Cooper, RA Eilers, DB AF Cooper, RA Eilers, DB TI Mammographic findings in basal cell carcinoma of the male nipple SO AMERICAN JOURNAL OF ROENTGENOLOGY LA English DT Article C1 Loyola Univ, Med Ctr, Dept Radiol, Maywood, IL 60153 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Dermatol Sect, Dept Internal Med, Hines, IL 60141 USA. RP Cooper, RA (reprint author), Loyola Univ, Med Ctr, Dept Radiol, 2160 S 1st Ave, Maywood, IL 60153 USA. NR 8 TC 8 Z9 8 U1 0 U2 1 PU AMER ROENTGEN RAY SOC PI RESTON PA 1891 PRESTON WHITE DR, SUBSCRIPTION FULFILLMENT, RESTON, VA 22091 USA SN 0361-803X J9 AM J ROENTGENOL JI Am. J. Roentgenol. PD OCT PY 2000 VL 175 IS 4 BP 1065 EP 1066 PG 2 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 357GQ UT WOS:000089490500026 PM 11000166 ER PT J AU Sankar, R Shin, D Mazarati, AM Liu, HT Katsumori, H Lezama, R Wasterlain, CG AF Sankar, R Shin, D Mazarati, AM Liu, HT Katsumori, H Lezama, R Wasterlain, CG TI Epileptogenesis after status epilepticus reflects age- and model-dependent plasticity SO ANNALS OF NEUROLOGY LA English DT Article ID SUSTAINING STATUS EPILEPTICUS; PAIRED-PULSE INHIBITION; INDUCED NEURONAL INJURY; TEMPORAL-LOBE EPILEPSY; DENTATE GYRUS; RAT-BRAIN; C-FOS; FEBRILE SEIZURES; SYNAPTIC REORGANIZATION; ELECTRICAL-STIMULATION AB Although epilepsy often begins in childhood, factors that contribute to the development of epilepsy as a consequence of status epilepticus (SE) during early development are poorly understood. We investigated animal models in which seizure-induced epileptogenicity could be studied. Rats undergoing self-sustaining SE induced by perforant path stimulation (PPS) at the ages of postnatal day 21 (P21) and P35 were compared with those subjected to SE by lithium and pilocarpine (LiPC). Although only one animal subjected to PPS at P21 developed chronic spontaneous seizures by several months of observation, all the animals subjected to PPS at P35 became epileptic. In the LiPC model, however, most of the rat pups subjected to SE at P21 became epileptic. Animals with spontaneous seizures showed increased inhibition in the dentate gyrus, a characteristic of the epileptic brain, with evidence of mossy fiber synaptic reorganization. Examination of circuit recruitment by c-Jun immunohistochemistry showed activation restricted to the hippocampus in P21 animals subjected to PPS, although extensive activation of hippocampal and extrahippocampal structures was seen in pups subjected to PPS-induced self-sustaining SE at P35 or LiPC SE at P21. These results demonstrate that the appearance of epilepsy as a consequence of SE is influenced by the type of insult as well as by age-dependent circuit recruitment. C1 Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Neurol Serv, Sepulveda, CA USA. RP Sankar, R (reprint author), Univ Calif Los Angeles, Sch Med, Dept Neurol, 22-474 MDCC,Box 951752, Los Angeles, CA 90095 USA. FU NINDS NIH HHS [NS01792, NS13515] NR 51 TC 97 Z9 99 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0364-5134 J9 ANN NEUROL JI Ann. Neurol. PD OCT PY 2000 VL 48 IS 4 BP 580 EP 589 DI 10.1002/1531-8249(200010)48:4<580::AID-ANA4>3.0.CO;2-B PG 10 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 360DD UT WOS:000089650400004 PM 11026441 ER PT J AU Grover, FL Edwards, FH AF Grover, FL Edwards, FH TI Similarity between the STS and New York State databases for valvular heart disease SO ANNALS OF THORACIC SURGERY LA English DT Editorial Material C1 Univ Colorado, Hlth Sci Ctr, Div Cardiothorac Surg C310, Denver, CO 80262 USA. Denver VA Med Ctr, Surg Serv, Denver, CO USA. Univ Florida, Div Cardiothorac Surg, Jacksonville, FL USA. RP Grover, FL (reprint author), Univ Colorado, Hlth Sci Ctr, Div Cardiothorac Surg C310, 4200 E 9th Ave, Denver, CO 80262 USA. NR 3 TC 14 Z9 14 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0003-4975 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD OCT PY 2000 VL 70 IS 4 BP 1143 EP 1144 DI 10.1016/S0003-4975(00)02168-8 PG 2 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 365AE UT WOS:000089925600003 PM 11081859 ER PT J AU Kirkpatrick, WR McAtee, RK Fothergill, AW Rinaldi, MG Patterson, TF AF Kirkpatrick, WR McAtee, RK Fothergill, AW Rinaldi, MG Patterson, TF TI Efficacy of voriconazole in a guinea pig model of disseminated invasive aspergillosis SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID IN-VITRO ACTIVITIES; AMPHOTERICIN-B; ITRACONAZOLE; FUMIGATUS; UK-109,496; SUSCEPTIBILITIES; FLUCONAZOLE; INFECTION; CANDIDA; FUNGI AB Voriconazole (VRC) was evaluated in an immunosuppressed-guinea pig model of invasive aspergillosis. VRC was more effective than amphotericin B or similar doses of itraconazole in the clearance of Aspergillus from tissues. VRC treatment regimens improved survival and significantly reduced tissue colony counts compared with those of controls. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX 78284 USA. RP Kirkpatrick, WR (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, Mail Code 7881,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 21 TC 58 Z9 61 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD OCT PY 2000 VL 44 IS 10 BP 2865 EP 2868 DI 10.1128/AAC.44.10.2865-2868.2000 PG 4 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 355TK UT WOS:000089402300047 PM 10991875 ER PT J AU Wolozin, B Kellman, W Ruosseau, P Celesia, GG Siegel, G AF Wolozin, B Kellman, W Ruosseau, P Celesia, GG Siegel, G TI Decreased prevalence of Alzheimer disease associated with 3-hydroxy-3-methyglutaryl coenzyme A reductase inhibitors SO ARCHIVES OF NEUROLOGY LA English DT Article ID APOLIPOPROTEIN-E; TOTAL CHOLESTEROL; PROTEIN; TRANSPORT; ALLELE; ONSET; AGE AB Context: Increasing evidence suggests that cholesterol plays a role in the pathophysiology of Alzheimer disease (AD). For instance, an elevated serum cholesterol level has been shown to be a risk factor for AD. Objective: To determine whether patients taking 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins), which are a group of medicines that inhibit the synthesis of cholesterol, have a lower prevalence of probable AD. Design: The experiment uses a cross-sectional analysis comparing the prevalence of probable AD in 3 groups of patients from hospital records: the entire population, patients receiving 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (hereafter referred to as the statins), and patients receiving medications used to treat hypertension or cardiovascular disease. Patients: The subjects studied were those included in the computer databases of 3 different hospitals for the years October 1, 1996, through August 31, 1998. Main Outcome Measures: Diagnosis of probable AD. Results: We find that the prevalence of probable AD in the cohort taking statins during the study interval is 60% to 73% (P<.001) lower than the total patient population or compared with patients taking other medications typically used in the treatment of hypertension or cardiovascular disease. Conclusions: There is a lower prevalence of diagnosed probable AD in patients taking 2 different 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors-lovastatin and pravastatin. While one cannot infer causative mechanisms based on these data, this study reveals an interesting association in the data, which warrants further study. C1 Loyola Univ, Med Ctr, Dept Pharmacol, Maywood, IL 60153 USA. Loyola Univ, Med Ctr, Dept Neurol, Maywood, IL 60153 USA. Loyola Univ, Med Ctr, Dept Biochem, Maywood, IL 60153 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Dept Neurol, Hines, IL 60141 USA. Carl T Hayden Vet Affairs Med Ctr, Dept Geriatr & Extended Care Med, Phoenix, AZ USA. RP Wolozin, B (reprint author), Loyola Univ, Med Ctr, Dept Pharmacol, Bldg 102,Room 3634,2160 S 1st Ave, Maywood, IL 60153 USA. OI Wolozin, Benjamin/0000-0003-2068-1475 NR 17 TC 1047 Z9 1085 U1 1 U2 16 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD OCT PY 2000 VL 57 IS 10 BP 1439 EP 1443 DI 10.1001/archneur.57.10.1439 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 363EB UT WOS:000089821200005 PM 11030795 ER PT J AU Burns, SP Little, JW Hussey, JL Lyman, P Lakshminarayanan, S AF Burns, SP Little, JW Hussey, JL Lyman, P Lakshminarayanan, S TI Sleep apnea syndrome in chronic spinal cord injury: Associated factors and treatment SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Spinal-Injury-Association CY APR 18-22, 1999 CL ATLANTA, GEORGIA SP Amer Spinal Injury Assoc DE rehabilitation; sleep apnea syndromes; spinal cord injuries ID POSITIVE AIRWAY PRESSURE; PULMONARY-HYPERTENSION; DAYTIME SLEEPINESS; RISK-FACTORS; SCALE; DISTURBANCES; TETRAPLEGIA; POPULATION; ACCIDENTS; HYPOPNEA AB Objective: To determine the prevalence of sleep apnea in a sample of persons with chronic spinal cord injury (SCI) of varying injury levels and degrees of impairment. Design: Cross-sectional study. Setting: Inpatient SCI rehabilitation unit. Participants: Twenty men with SCI (motor complete and incomplete; American Spinal Injury Association classes A-D) of at least 1 year's duration, randomly selected from patients with SCI undergoing elective hospitalization. Main Outcome Measures: Apnea index, determined by sleep study (including chest wall movement, airflow, oxygen saturation), and daytime sleepiness, determined by Epworth sleepiness score. Results: Eight subjects (40%) had sleep apnea, manifested by elevated apnea index (mean +/- SD, 17.1 +/- 6-9) and excessive daytime sleepiness. Sleep apnea was commonly diagnosed in motor-incomplete injuries. A trend (p = .07) existed toward a greater prevalence of sleep apnea with tetraplegia. Age and body mass index were not associated with sleep apnea. Conclusion: The prevalence of sleep apnea in men with chronic SCI admitted for nonrespiratory elective hospitalization is high relative to the general population. C1 Vet Affairs Puget Sound Hlth Care Syst, Pulm Serv, Seattle, WA 98108 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Div Pulm & Crit Care Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Spinal Cord Injury Serv, Seattle, WA 98108 USA. RP Burns, SP (reprint author), VA Puget Sound Hlth Care Syst, SCI Serv 128, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 42 TC 45 Z9 46 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD OCT PY 2000 VL 81 IS 10 BP 1334 EP 1339 DI 10.1053/apmr.2000.9398 PG 6 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 360WA UT WOS:000089689300003 PM 11030498 ER PT J AU Fitzsimmons, TJ Gukovsky, I McRoberts, JA Rodriguez, E Lai, FA Pandol, SJ AF Fitzsimmons, TJ Gukovsky, I McRoberts, JA Rodriguez, E Lai, FA Pandol, SJ TI Multiple isoforms of the ryanodine receptor are expressed in rat pancreatic acinar cells SO BIOCHEMICAL JOURNAL LA English DT Article DE calcium-induced calcium release; intracellular calcium store; palmitoyl-coenzyme A ID MUSCLE SARCOPLASMIC-RETICULUM; CALCIUM RELEASE CHANNEL; SKELETAL-MUSCLE; CA2+ RELEASE; EXOCRINE PANCREAS; MOLECULAR-CLONING; COENZYME-A; OSCILLATIONS; CDNA; PROPAGATION AB Regulation of cytosolic Ca2+ is important for a variety of cell functions. The ryanodine receptor (RyR) is a Ca2+ channel that conducts Ca2+ from internal pools to the cytoplasm. To demonstrate the presence of the RyR in the pancreatic acinar cell, we performed reverse transcriptase (RT)-PCR, Western blot, immunocytochemistry and microscopic Ca2+-release measurements on these cells. RT-PCR showed the presence of mRNA for RyR isoforms 1, 2 and 3 in both rat pancreas and dispersed pancreatic acini. Furthermore, mRNA expression for RyR isoforms 1 and 2 was demonstrated by RT-PCR in individual pancreatic acinar cells selected under the microscope. Western-blot analysis of acinar cell immunoprecipitates, using antibodies against RyR1 and RyR2, showed a high-molecular-mass (> 250 kDa) protein band that was much less intense when immunoprecipitated in the presence of RyR peptide. Functionally, permeablized acinar cells stimulated with the RyR activator, palmitoyl-CoA, released Ca2+ from both basolateral and apical regions. These data show that pancreatic acinar cells express multiple isoforms of the RyR and that there are functional receptors throughout the cell. C1 Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, W Los Angeles, CA 90073 USA. Univ Wales Coll Med, Cardiff CF4 4XN, S Glam, Wales. RP McRoberts, JA (reprint author), Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, W Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK 33010] NR 34 TC 47 Z9 48 U1 0 U2 0 PU PORTLAND PRESS PI LONDON PA 59 PORTLAND PLACE, LONDON W1N 3AJ, ENGLAND SN 0264-6021 J9 BIOCHEM J JI Biochem. J. PD OCT 1 PY 2000 VL 351 BP 265 EP 271 DI 10.1042/0264-6021:3510265 PN 1 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 364RW UT WOS:000089907600030 PM 10998370 ER PT J AU Brodsky, MB McNeil, MR Park, GH Fossett, TRD Timm, NH Doyle, PJ AF Brodsky, MB McNeil, MR Park, GH Fossett, TRD Timm, NH Doyle, PJ TI Serial-position effects for information unit production: The role of memory in the RAPP story retell procedure for normals and persons with aphasia SO BRAIN AND LANGUAGE LA English DT Article C1 Univ Pittsburgh, Dept Commun Sci & Disorders, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Educ Psychol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Otolaryngol, Pittsburgh, PA 15260 USA. VA Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Aphasia Rehabil Res Lab & Clin, Pittsburgh, PA USA. RP Brodsky, MB (reprint author), Univ Pittsburgh, 4033 Forbes Tower, Pittsburgh, PA 15260 USA. NR 6 TC 0 Z9 0 U1 0 U2 0 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0093-934X J9 BRAIN LANG JI Brain Lang. PD OCT 1 PY 2000 VL 74 IS 3 BP 494 EP 498 PG 5 WC Audiology & Speech-Language Pathology; Linguistics; Neurosciences; Psychology, Experimental SC Audiology & Speech-Language Pathology; Linguistics; Neurosciences & Neurology; Psychology GA 358FH UT WOS:000089547200058 ER PT J AU Hersh, WR Crabtree, MK Hickam, DH Sacherek, L Rose, L Friedman, CP AF Hersh, WR Crabtree, MK Hickam, DH Sacherek, L Rose, L Friedman, CP TI Factors associated with successful answering of clinical questions using an information retrieval system SO BULLETIN OF THE MEDICAL LIBRARY ASSOCIATION LA English DT Article ID FRAMEWORK; RELEVANCE; STUDENTS AB Objectives: Despite the growing use of online databases by clinicians, there has been very little research documenting how effectively they are used. This study assessed the ability of medical and nurse-practitioner students to answer clinical questions using an information retrieval system. It also attempted to identify the demographic, experience, cognitive, personality, search mechanics, and user-satisfaction factors associated with successful use of a retrieval system. Methods: Twenty-nine students completed questionnaires of clinical and computer experience as well as tests of cognitive abilities and personality type. They were then administered three clinical questions to answer in a medical library setting using the MEDLINE database and electronic and print full-text resources. Results: Medical students were able to answer more questions correctly than nurse-practitioner students before and after searching, but both had comparable improvements in the number of correct questions before and after searching. Successful ability to answer questions was also associated with having experience in literature searching and higher standardized test-score percentiles. Conclusions: Medical and nurse-practitioner students obtained comparable benefits in the ability to answer clinical questions from use of the information retrieval system. Future research must examine strategies that improve successful search and retrieval of clinical questions posed by clinicians in practice. C1 Oregon Hlth Sci Univ, Div Med Informat & Outcomes Res, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Sch Nursing, Portland, OR 97201 USA. Portland VA Med Ctr, Hlth Serv Res & Dev, Portland, OR USA. Univ Pittsburgh, Ctr Biomed Informat, Pittsburgh, PA USA. RP Hersh, WR (reprint author), Oregon Hlth Sci Univ, Div Med Informat & Outcomes Res, 3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. OI Hersh, William/0000-0002-4114-5148 FU NLM NIH HHS [LM-06311] NR 27 TC 36 Z9 36 U1 0 U2 2 PU MEDICAL LIBRARY ASSOC PI CHICAGO PA 65 EAST WACKER PLACE, STE 1900, CHICAGO, IL 60601-7298 USA SN 0025-7338 J9 B MED LIBR ASSOC JI Bull. Med. Libr. Assoc. PD OCT PY 2000 VL 88 IS 4 BP 323 EP 331 PG 9 WC Information Science & Library Science SC Information Science & Library Science GA 530JT UT WOS:000174355100004 PM 11055299 ER PT J AU Blahd, WH AF Blahd, WH TI Benedict Cassen: The father of body organ imaging - Historical vignette SO CANCER BIOTHERAPY AND RADIOPHARMACEUTICALS LA English DT Biographical-Item AB The invention of the radioisotope scanner by Benedict Cassen was seminal to the development of body organ imaging. Cassen assembled the first automated scanning system in 1950. It was a motor-driven scintillation detector coupled to a printer. The scanner was used to image the thyroid gland after the administration of radioiodine. Later, with the development of organ-specific radiopharmaceuticals the scanner was widely used during the late 50s until the early 70s to image the body organs. C1 Vet Adm Greater Los Angeles Healthcare Syst, Nucl Med Sect 115, Imaging Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. RP Blahd, WH (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, Nucl Med Sect 115, Imaging Serv, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 1 TC 1 Z9 1 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1084-9785 J9 CANCER BIOTHER RADIO JI Cancer Biother. Radiopharm. PD OCT PY 2000 VL 15 IS 5 BP 423 EP 429 DI 10.1089/cbr.2000.15.423 PG 7 WC Oncology; Medicine, Research & Experimental; Pharmacology & Pharmacy; Radiology, Nuclear Medicine & Medical Imaging SC Oncology; Research & Experimental Medicine; Pharmacology & Pharmacy; Radiology, Nuclear Medicine & Medical Imaging GA 376AP UT WOS:000165435900001 PM 11155815 ER PT J AU Dodds, MWJ Yeh, CK Johnson, DA AF Dodds, MWJ Yeh, CK Johnson, DA TI Salivary alterations in type 2 (non-insulin-dependent) diabetes mellitus and hypertension SO COMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY LA English DT Article DE diabetes mellitus; non-insulin-dependent; hypertension; saliva; salivary glands; salivary proteins ID AUTONOMIC NERVOUS-SYSTEM; FLOW-RATE; HUMAN MYELOPEROXIDASE; HIV-1 INFECTION; GLAND FUNCTION; PAROTID-GLAND; WHOLE SALIVA; LACTOFERRIN; PROTEINS; DISEASES AB Objectives: The aim of this study was to determine whether saliva output and composition are altered in type 2 diabetes mellitus by comparison with a healthy, non-medicated control group, and also a roup of hypertensives. Methods: From a community-dwelling cohort of Mexican American and European American subjects enrolled in the OH:SALSA oral aging study, we identified 233 subjects with type 2 diabetes mellitus, 227 with hypertension, and 240 healthy control subjects. We collected unstimulated whole (UW) and submandibular/ sublingual (US) saliva, as well as stimulated parotid (SP) and submandibular/ sublingual (SS) saliva. Flow rates were determined, yeast carriage was assayed in UW saliva, and SP and SS saliva samples were analyzed for protein composition. ELISA was used to determine concentrations of an array of specific protein components, with both antimicrobial and other activities. Results: Both diabetic and hypertensive subjects had reduced output of both stimulated and unstimulated submandibular/sublingual saliva. 30% of the diabetic subjects had high oral yeast counts (greater than or equal to 1000 cfu/mL) compared with 17% of the healthy subjects and 20% of the hypertensives. Significant increases in the concentrations of a number of the protein components were found in the diabetic subjects, specifically, SP lactsferrin, myeloperoxidase (MPO), and salivary peroxidase (SPO), as well as SS total protein, albumin, lactoferrin and secretory IgA. Conclusions: The pattern of decreased flow rates and increased protein concentrations were similar, but consisitently greater in diabetics than hypertensives, suggesting that disease-specific mechanisms may be responsible. Diabetics may be more prone to oral dryness and infections than non-diabetics. C1 Univ Texas, Hlth Sci Ctr, Dept Community Dent, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Dodds, MWJ (reprint author), Univ Texas, Hlth Sci Ctr, Dept Community Dent, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NIDCR NIH HHS [DE10756] NR 57 TC 54 Z9 58 U1 0 U2 7 PU MUNKSGAARD INT PUBL LTD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 0301-5661 J9 COMMUNITY DENT ORAL JI Community Dentist. Oral Epidemiol. PD OCT PY 2000 VL 28 IS 5 BP 373 EP 381 DI 10.1034/j.1600-0528.2000.028005373.x PG 9 WC Dentistry, Oral Surgery & Medicine; Public, Environmental & Occupational Health SC Dentistry, Oral Surgery & Medicine; Public, Environmental & Occupational Health GA 356KC UT WOS:000089441600007 PM 11014514 ER PT J AU Suarez-Almazor, ME Belseck, E Homik, J Dorgan, M Ramos-Remus, C AF Suarez-Almazor, ME Belseck, E Homik, J Dorgan, M Ramos-Remus, C TI Identifying clinical trials in the medical literature with electronic databases: MEDLINE alone is not enough SO CONTROLLED CLINICAL TRIALS LA English DT Article DE MEDLINE; EMBASE; on-line databases; clinical trials; rheumatic diseases ID RANDOMIZED CONTROLLED TRIALS; BIBLIOGRAPHIC DATABASES; BIOMEDICAL DATABASES; LITERATURE SEARCHES; PERFORMANCE; RETRIEVAL; RELEVANT; QUALITY; CARE AB The objective of this study was to compare the performance of MEDLINE and EMBASE for the identification of articles regarding controlled clinical trials (CCTs) published in English and related to selected topics: rheumatoid arthritis (RA), osteoporosis (OP), and low back pain (LBP). MEDLINE and EMBASE were searched for literature published in 1988 and 1994. The initial selection of papers was then reviewed to confirm that the articles were about CCTs and to assess the quality of the studies. Selected journals were also hand searched to identify CCTs not retrieved by either database. Overall, 4111 different references were reviewed (2253 for RA, 978 for OF, and 880 for LBP); 3418 (83%) of the papers were in English. EMBASE retrieved 78% more references than MEDLINE (2895 versus 1625). Overall, 1217 (30%) of the papers were retrieved by both databases. Two hundred forty-three papers were about CCTs. Two-thirds of these were retrieved by both databases, and one-third by only one. An additional 16 CCTs not retrieved by either database were identified through hand searching. Taking these into account, EMBASE retrieved 16% more CCTs than MEDLINE (220 versus 188); the EMBASE search identified 85% of the CCTs compared to 73% by MEDLINE. No significant differences were observed in the mean quality scores and sample size of the CCTs missed by MEDLINE compared to those missed by EMBASE. Our findings suggest that the use of MEDLINE alone to identify CCTs is inadequate. The use of two or more databases and hand searching of selected journals are needed to perform a comprehensive searches. (C) Elsevier Science Inc. 2000. C1 Baylor Coll Med, Houston, TX 77030 USA. Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB T6G 2M7, Canada. Inst Mexicano Seguro Social, Guadalajara, Jalisco, Mexico. RP Suarez-Almazor, ME (reprint author), Vet Affairs Med Ctr 152, Hlth Serv Res, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 29 TC 95 Z9 96 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0197-2456 J9 CONTROL CLIN TRIALS JI Controlled Clin. Trials PD OCT PY 2000 VL 21 IS 5 BP 476 EP 487 DI 10.1016/S0197-2456(00)00067-2 PG 12 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 361AH UT WOS:000089699200005 PM 11018564 ER PT J AU Hickey, RW Ferimer, H Alexander, HL Garman, RH Callaway, CW Hicks, S Safar, P Graham, SH Kochanek, PM AF Hickey, RW Ferimer, H Alexander, HL Garman, RH Callaway, CW Hicks, S Safar, P Graham, SH Kochanek, PM TI Delayed, spontaneous hypothermia reduces neuronal damage after asphyxial cardiac arrest in rats SO CRITICAL CARE MEDICINE LA English DT Article DE cerebral ischemia; temperature; hypothermia; rat; cardiac arrest; postischemic hypothermia; resuscitation; neuronal damage; cardiopulmonary resuscitation; neuroprotection ID MODERATE HYPOTHERMIA; POSTISCHEMIC HYPOTHERMIA; CEREBRAL RESUSCITATION; BRAIN TEMPERATURE; CARDIOPULMONARY-RESUSCITATION; INJURY; ISCHEMIA; DOGS; MINUTES; GERBIL AB Objective: Core temperature is reduced spontaneously after asphyxial cardiac arrest in rats. To determine whether spontaneous hypothermia influences neurologic damage after asphyxial arrest, we compared neurologic outcome in rats permitted to develop spontaneous hypothermia vs. rats managed with controlled normothermia. Interventions Male Sprague-Dawley rats were asphyxiated for 8 mins and resuscitated. After extubation, a cohort of rats was managed with controlled normothermia (CN) by placement in a servo-controlled incubator set to maintain rectal temperature at 37.4 degrees C for 48 hrs. CN rats were compared with permissive hypothermia (PH) rats that were returned to an ambient temperature environment after extubation. Rats were killed at either 72 hrs (PH72hr, n = 14; CN72hr, n = 9) or 6 wks (PH6wk, n = 6, CN6wk, n = 6) after resuscitation. PH72 rats were historic controls for the CN72 rats, whereas PH6 and CN6 rats were randomized and studied contemporaneously. Measurements: A clinical neurodeficit score (NDS) was determined daily. A pathologist blinded to group scored 40 hematoxylin and eosin-stained brain regions for damage by using a 5-point scale (0 = none, 5 = severe). Quantitative analysis of CA1 hippocampus injury was performed by counting normal-appearing neurons in a defined subsection of CA1. Main Results: Mean rectal temperatures measured in the PH6wk rats (n = 6) were 36.9, 34.8, 35.5, 36.7, and 37.4 degrees C at 2, 8, 12, 24, and 36 hrs, respectively. Mortality rate (before termination) was lower in PH compared with CN (0/20 vs. 7/15; p < .005). PH demonstrated a more favorable progression of NDS (p = .04) and less weight loss (P < .005) compared with CN. Median histopathology scores were lower (less damage) in PH72hr vs. CN72hr for temporal cortex (0 vs. 2.5), parietal cortex (0 vs. 2), thalamus (0 vs. 3), CA1 hippocampus (1.5 vs. 4.5), CA2 hippocampus (0 vs. 3.5), subiculum (0 vs. 4), and cerebellar Purkinje cell layer (2 vs. 4) (all p < .05). There was almost complete loss of normal-appearing CA1 neurons in CN72hr rats (6 +/- 2 [mean +/- SD] normal neurons compared with 109 +/- 12 in naive controls). In contrast, PH72hr rats demonstrated marked protection (97 +/- 23 normal-appearing neurons) that was still evident, although attenuated, at 6 wks (42 +/- 24 normal-appearing neurons, PH6wk). Conclusion: Rats resuscitated from asphyxial cardiac arrest develop delayed, mild to moderate, prolonged hypothermia that is neuroprotective. C1 Univ Pittsburgh, Childrens Hosp Pittsburgh, Dept Pediat, Div Pediat Emergency Med, Pittsburgh, PA 15213 USA. Mercy Hosp, Dept Pediat, Pittsburgh, PA USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Pittsburgh, PA 15260 USA. Consultants Vet Pathol Inc, Murrysville, PA USA. Univ Pittsburgh, Vet Affairs Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Dept Emergency Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Vet Affairs Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Dept Neurol, Pittsburgh, PA 15260 USA. RP Hickey, RW (reprint author), Univ Pittsburgh, Childrens Hosp Pittsburgh, Dept Pediat, Div Pediat Emergency Med, 3705 5th Ave, Pittsburgh, PA 15213 USA. RI Kochanek, Patrick/D-2371-2015 OI Kochanek, Patrick/0000-0002-2627-913X NR 41 TC 72 Z9 79 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD OCT PY 2000 VL 28 IS 10 BP 3511 EP 3516 DI 10.1097/00003246-200010000-00027 PG 6 WC Critical Care Medicine SC General & Internal Medicine GA 365CT UT WOS:000089931400020 PM 11057809 ER PT J AU Christian, M Yeung, L Williams, R Lapinski, P Moy, R AF Christian, M Yeung, L Williams, R Lapinski, P Moy, R TI Conscious sedation in dermatologic surgery SO DERMATOLOGIC SURGERY LA English DT Review ID ANESTHESIA; ALFENTANIL; PROPOFOL; FENTANYL C1 Univ Texas, SW Med Ctr, Dept Dermatol, Dallas, TX 75235 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Christian, M (reprint author), Univ Texas, SW Med Ctr, Dept Dermatol, 5323 Harry Hines Blvd, Dallas, TX 75235 USA. NR 30 TC 5 Z9 5 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 1076-0512 J9 DERMATOL SURG JI Dermatol. Surg. PD OCT PY 2000 VL 26 IS 10 BP 923 EP 928 DI 10.1046/j.1524-4725.2000.026010923.x PG 6 WC Dermatology; Surgery SC Dermatology; Surgery GA 362RA UT WOS:000089791000005 PM 11050494 ER PT J AU Levin, SR Coburn, JW Abraira, C Henderson, WG Colwell, JA Emanuele, NV Nuttall, FQ Sawin, CT Comstock, JP Silbert, CK AF Levin, SR Coburn, JW Abraira, C Henderson, WG Colwell, JA Emanuele, NV Nuttall, FQ Sawin, CT Comstock, JP Silbert, CK CA Vet Affairs Cooperative Study Glyc TI Effect of intensive glycemic control on microalbuminuria in type 2 diabetes SO DIABETES CARE LA English DT Article ID VA CSDM; FEASIBILITY TRIAL; CREATININE CLEARANCE; NIDDM PATIENTS; HEART-DISEASE; COMPLICATIONS; MELLITUS; INSULIN; PROGRESSION; THERAPY AB OBJECTIVE - Microalbuminuria can reflect the progress of microvascular complications and may be predictive of macrovascular disease in type 2 diabetes. The effect of intensive glycemic control on microalbuminuria in patients in the U.S. who have had type 2 diabetes for several years has not previously been evaluated. RESEARCH DESIGN AND METHODS - We randomly assigned 153 male patients to either intensive treatment (INT) (goal HbA(1c) 7.1%) or to standard treatment (ST) (goal HbA(1c) 9.1% P = 0.001), and data were obtained during a 2-year period. Mean duration of known diabetes was 8 years, mean age of the patients was 60 years, and patients were well matched at baseline. We obtained 3-h urine samples for each patient at baseline and annually and defined microalbuminuria as an albumin:creatinine ratio of 0.03-030. All patients were treated with insulin and received instructions regarding diet and exercise. Hypertension and dyslipidemia were treated with similar goals in each group. RESULTS - A total of 38% of patients had microalbuminuria at entry and were evenly assigned to both treatment groups. INT retarded the progression of microalbuminuria during the 2-year period: the changes in albumin:creatinine ratio from baseline to 2 years of INT versus ST were 0.045 vs. 0.141, respectively (P = 0.046). Retardation of progressive urinary albumin excretion was most pronounced in those patients who entered the study with microalbuminuria and were randomized to INT. Patients entering with microalbuminuria had a deterioration in creatinine clearance at 2 years regardless of the intensity of glycemic control. In the group entering without microalbuminuria, the subgroup receiving ST had a lower percentage of patients with a macrovascular event (17%) than the subgroup receiving INT (36%) (P = 0.03). Use of ACE inhibitors or calcium-channel blockers was similarly distributed among the groups. CONCLUSIONS - Intensive glycemic control retards microalbuminuria in patients who have had type 2 diabetes for several years but may not lessen the progressive deterioration of glomerular function. Increases in macrovascular event rates in the subgroup entering without albuminuria who received INT remain unexplained but could reflect early worsening, as observed with microvascular disease in the Diabetes Control and Complications Trial. C1 W Los Angeles Vet Affairs Med Ctr, Vet Affairs Greater Los Angeles Healthcare Syst, Med Serv 111K, Los Angeles, CA 90073 USA. Edward Hines Jr Vet Adm Med Ctr, Hines, IL USA. Minneapolis Vet Affairs Med Ctr, Minneapolis, MN USA. Boston Vet Affairs Med Ctr, Boston, MA USA. Charleston Vet Affairs Med Ctr, Charleston, SC USA. Houston Vet Affairs Med Ctr, Houston, TX USA. RP Levin, SR (reprint author), W Los Angeles Vet Affairs Med Ctr, Vet Affairs Greater Los Angeles Healthcare Syst, Med Serv 111K, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 43 TC 53 Z9 57 U1 0 U2 2 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD OCT PY 2000 VL 23 IS 10 BP 1478 EP 1485 DI 10.2337/diacare.23.10.1478 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 357RB UT WOS:000089513700007 PM 11023140 ER PT J AU Kahn, SE Andrikopoulos, S Verchere, CB Wang, F Hull, RL Vidal, J AF Kahn, SE Andrikopoulos, S Verchere, CB Wang, F Hull, RL Vidal, J TI Oophorectomy promotes islet amyloid formation in a transgenic mouse model of Type II diabetes SO DIABETOLOGIA LA English DT Article DE islet amyloid; islet amyloid polypeptide; amylin; oophorectomy; oestrogen; glucose tolerance; diabetes; Alzheimer's disease ID POLYPEPTIDE; MICE AB Aims/hypothesis. In Type II (non-insulin-dependent) diabetes mellitus, amyloid depletes islet mass. We previously found that 81% of male human islet amyloid polypeptide (IAPP) transgenic mice but only 11% of female mice developed islet amyloid, suggesting that either testosterone promotes or ovarian products protect against amyloid deposition. Methods. We did a bilateral oophorectomy or sham procedure in female human IAPP transgenic mice (n = 11 and n = 8, respectively) and in female non-transgenic mice (n = 7 and n = 9, respectively) at 6-8 weeks of age. Animals were followed for 1 year on a 9 % fat (w/w) diet. Before we killed them we measured, fasting plasma human IAPP and did an intraperitoneal glucose tolerance test. Pancreatic content of IAPP and immunoreactive insulin (IRI) were estimated and pancreata were analysed for islet amyloid. Results. No amyloid was detected in either the sham-operated transgenic mice or, as expected, in both groups of non-transgenic mice. In strong contrast, 7 of 11 (64%) oophorectomized mice developed islet amyloid (p < 0.05). Amyloid deposition in the oophorectomized transgenic mice was not associated with any differences in incremental body weight, fasting human IAPP concentrations or glucose tolerance between the groups. Furthermore, pancreatic content of mouse IAPP, human IAPP and immunoreactive insulin did not differ between groups. Conclusion/interpretation. Oophorectomy is associated with an enhancement of islet amyloid formation in the absence of changes in glucose tolerance, circulating IAPP or pancreatic content of IRI, mouse or human IAPP. Thus, the early stages of islet amyloidogenesis seem to be independent of glucose tolerance, with ovarian products having a protective role. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Div Metab Endocrinol & Nutr, Dept Med, Seattle, WA 98195 USA. RP Kahn, SE (reprint author), VA Puget Sound Hlth Care Syst, 151,1660 S Columbian Way, Seattle, WA 98108 USA. OI Kahn, Steven/0000-0001-7307-9002; Hull, Rebecca/0000-0001-9690-4087 FU NIDDK NIH HHS [DK-17047, DK-50703] NR 10 TC 18 Z9 18 U1 0 U2 1 PU SPRINGER-VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD OCT PY 2000 VL 43 IS 10 BP 1309 EP 1312 DI 10.1007/s001250051527 PG 4 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 365BD UT WOS:000089927800013 PM 11079750 ER PT J AU Gorelik, Y Damron-Rodriguez, J Funderburk, B Solomon, DH AF Gorelik, Y Damron-Rodriguez, J Funderburk, B Solomon, DH TI Undergraduate interest in aging: Is it affected by contact with older adults? SO EDUCATIONAL GERONTOLOGY LA English DT Article ID NURSING-STUDENTS ATTITUDES; SOCIAL-WORK STUDENTS; MEDICAL-STUDENTS; GERONTOLOGICAL EDUCATION; GERIATRIC EDUCATION; PHYSICAL THERAPY; ELDERLY PEOPLE; KNOWLEDGE; PREFERENCES; PERCEPTIONS AB Undergraduate student interest in aging was examined in, elation to age, gender; and contact with older adults. Interest in aging is conceived of along a continuum, ranging from initial interest-taking an aging course-to substantial interest as evidenced by academic and career interest. Undergraduate students who have taken an aging course (n = 189) and a stratified, random comparison group (n = 261) self-assessed their interest in aging. Background information, including the frequency and duration of contact with older family and non-family individuals, individuals, was reported. Being female (p < 001) and having frequent contact with older family members (p < .01) significantly explains initial interest in aging. Initial interest in aging (i.e., taking an aging course) significantly contributes to substantial interest in aging (p < .0001) i.e., taking more aging courses, majoring in gerontology, working or planning to work with older adults. Contact with older adults positively affects undergraduate interest in aging. Interest in aging proceeds along a continuum, from preceding factors to initial interest in aging and then to substantial interest in aging. Aging courses and opportunities for interaction with older adults should be offered at the undergraduate level. C1 Univ Calif Los Angeles, Sch Publ Policy & Social Res, VA Geriat Res Educ & Clin Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP Damron-Rodriguez, J (reprint author), VA Greater Los Angeles Healthcare Syst, 11G,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 42 TC 24 Z9 24 U1 0 U2 4 PU HEMISPHERE PUBL CORP PI BRISTOL PA 1900 FROST ROAD, SUITE 101, BRISTOL, PA 19007-1598 USA SN 0360-1277 J9 EDUC GERONTOL JI Educ. Gerontol. PD OCT-NOV PY 2000 VL 26 IS 7 BP 623 EP 638 DI 10.1080/03601270050200626 PG 16 WC Education & Educational Research; Gerontology SC Education & Educational Research; Geriatrics & Gerontology GA 380BL UT WOS:000165678400002 ER PT J AU Roselle, GA Danko, LH Kralovic, SM Simbartl, LA Kizer, KW AF Roselle, GA Danko, LH Kralovic, SM Simbartl, LA Kizer, KW TI Tuberculosis in the veterans healthcare system: a six-year review and evaluation of programme effectiveness SO EPIDEMIOLOGY AND INFECTION LA English DT Review ID RESISTANT TUBERCULOSIS AB The Department of Veterans Affairs operates a large, centrally administered health care system consisting of 173 hospitals and 4 free standing outpatient clinics nationwide with approximately 945 115 hospital discharges, 24.2 million outpatient visits, and 2.86 million persons served annually over the time frame of the review. The purpose of the study was to define whether such a system could effect timely change in the incidence of tuberculosis (TB) using centralized programme planning and flexible field implementation. A retrospective review of the number of newly diagnosed cases of active TB treated at veterans health care facilities between 1 October 1990 and 30 September 1997 was determined by using a standardized annual case census. Intervention included implementation of the must current guidelines for the prevention of transmission of TB in the community and hospital setting, including administrative and engineering controls and a change in personal protective equipment. Centrally directed programme guidance, education, and funding were provided for field use in health care facilities of widely varying size and complexity. The numbers of total reported cases of TB decreased significantly (P < 0.001) throughout the veterans health care system (nationally and regionally), with the case rate decreasing at a rate significantly greater than that seen in the USA as a whole (P < 0.0001). TB associated with multi-drug resistance (isoniazid and rifampin) and HIV coinfection also significantly decreased over the study period. Therefore, a large, centrally administered health care system can effectively combat a re-emerging infectious disease and may also demonstrate a successful outcome greater than seen in other, perhaps less organized health care settings. C1 US Dept Vet Affairs, Vet Hlth Adm Headquarters, Washington, DC USA. Vet Adm Med Ctr, Cincinnati, OH 45220 USA. Univ Cincinnati, Coll Med, Cincinnati, OH USA. Univ Cincinnati, Inst Hlth Policy & Hlth Serv Res, Cincinnati, OH USA. RP Roselle, GA (reprint author), Vet Adm Med Ctr, 3200 Vine St, Cincinnati, OH 45220 USA. NR 30 TC 1 Z9 1 U1 0 U2 1 PU CAMBRIDGE UNIV PRESS PI PORT CHESTER PA 110 MIDLAND AVE, PORT CHESTER, NY 10573-4930 USA SN 0950-2688 J9 EPIDEMIOL INFECT JI Epidemiol. Infect. PD OCT PY 2000 VL 125 IS 2 BP 315 EP 323 DI 10.1017/S0950268899004409 PG 9 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 422BE UT WOS:000168097400010 PM 11117955 ER PT J AU Anawalt, BD Herbst, KL Matsumoto, AM Mulders, TMT Coelingh-Bennink, HJT Bremner, WJ AF Anawalt, BD Herbst, KL Matsumoto, AM Mulders, TMT Coelingh-Bennink, HJT Bremner, WJ TI Desogestrel plus testosterone effectively suppresses spermatogenesis but also causes modest weight gain and high-density lipoprotein suppression SO FERTILITY AND STERILITY LA English DT Article DE male hormonal contraception; spermatogenesis; oligoazoospermia; azoospermia; testosterone; gonadotropins; desogestrel ID MALE CONTRACEPTION; LEVONORGESTREL; GONADOTROPIN; CHOLESTEROL; ENANTHATE AB Objective: To test the hypothesis that oral desogestrel (DSG) plus testosterone would uniformly and rapidly suppress sperm concentrations in young men as effectively as levonorgestrel (LNG) plus testosterone and cause less high-density lipoprotein (HDL) suppression and weight gain. Design: Single-blind, randomized trial. Setting: VA Puget Sound and University of Washington, Seattle, Washington. Patient(s): Twenty-four healthy young men, aged 20-49. Intervention(s): Subjects were randomized to three groups of men who were administered 6 months of therapy with oral DSG plus im testosterone enanthate: 150 mu g of DSG plus 50 mu g of testosterone (DSG 150-T 50), 150 mu g of DSG plus 100 mg of testosterone (DSG 150-T 100) or 300 mu g of DSG plus 100 mg of testosterone (DSG 300-T 100). We compared these three groups to two groups of historical controls of 100 mg of im testosterone alone or 150 mu g of oral LNG plus 100 mg of im testosterone (LNG 125-T 100 group) enrolled in similar studies. Main Outcome Measure(s): Suppression of sperm counts to severe oligoazoospermia (sperm counts <1 X 10(6)/mL) and azoospermia, weight gain, and serum high-density cholesterol (HDL) suppression. Result(s): Azoospermia was achieved in all eight men receiving DSG 150-T 100 and seven of the right men in the DSG 300-T 100 group. DSG 150 or 300 plus T 100 suppressed spermatogenesis as effectively as LNG 125-T 100 and more effectively than DSG 150-T 100 or testosterone alone. All groups tended to gain weight compared with their baseline, but the weight gain was greatest land statistically significant) in the DSG 150-T 100, DSG 300-T 100, and LNG 125-T 100 groups. Serum HDL levels were modestly suppressed in all groups, and this effect was greatest in the DSG 300-T 100 and LNG 125-T 100 groups. Conclusion(s): The combination of DSG plus testosterone is a very effective regimen for suppression of spermatogenesis and has acceptably low side effects. (Fertil Steril (R) 2000;74:707-14. (C) 2000 by American Society for Reproductive Medicine.). C1 Univ Washington, Dept Med, Populat Ctr Res Reprod, Seattle, WA USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. NV Organon, Oss, Netherlands. RP Anawalt, BD (reprint author), S-111 VAPSHCS,1660 S Columbian Way, Seattle, WA 98108 USA. FU NICHD NIH HHS [HD 12629] NR 19 TC 51 Z9 51 U1 1 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0015-0282 J9 FERTIL STERIL JI Fertil. Steril. PD OCT PY 2000 VL 74 IS 4 BP 707 EP 714 DI 10.1016/S0015-0282(00)01490-4 PG 8 WC Obstetrics & Gynecology; Reproductive Biology SC Obstetrics & Gynecology; Reproductive Biology GA 362KY UT WOS:000089778200019 PM 11020511 ER PT J AU Chang, L Munakata, J Mayer, EA Schmulson, MJ Johnson, TD Bernstein, CN Saba, L Naliboff, B Anton, PA Matin, K AF Chang, L Munakata, J Mayer, EA Schmulson, MJ Johnson, TD Bernstein, CN Saba, L Naliboff, B Anton, PA Matin, K TI Perceptual responses in patients with inflammatory and functional bowel disease SO GUT LA English DT Article DE ulcerative colitis; irritable bowel syndrome; abdominal pain ID IRRITABLE-BOWEL; ULCERATIVE-COLITIS; RECTAL DISTENSION; VISCERAL PAIN; SENSITIVITY; HYPERALGESIA; DISORDERS; DYSPEPSIA; SYMPTOMS; OPIOIDS AB Background and aims-Enhanced visceral sensitivity following a transient inflammatory process in the got has been postulated as an aetiological mechanism of irritable bowel syndrome (IBS). In this study we compared perceptual responses to rectosigmoid distension in patients with mild chronic inflammation of the rectum (ulcerative colitis (UC)) and patients without mucosal inflammation (IBS) to determine if chronic low grade mucosal inflammation may be a plausible explanation for rectosigmoid hypersensitivity reported in both IBS and UC patients. Methods-UC disease activity was quantified using activity index scores. Perception thresholds for discomfort during rectosigmoid distension were compared between 11 UC patients with quiescent or mild disease activity, 18 IBS patients, and 13 healthy controls. Results-Although UC activity index scores negatively correlated with perceptual thresholds for discomfort (r=-0.76, p=0.016), UC patients had higher discomfort thresholds compared with IBS patients and controls before (p=0.02) and after (p<0.001) a noxious sigmoid conditioning stimulus. Conclusions-Rectal perception was attenuated in UC but enhanced in IBS. in chronic mild inflammation, activation of antinociceptive mechanisms may prevent the development of visceral hyperalgesia. Low grade mucosal inflammation alone is unlikely to be responsible for symptoms in functional gastrointestinal disorders. C1 Univ Calif Los Angeles, Dept Med & Physiol, Neuroenter Dis Program, W Los Angeles VA Med Ctr,Sch Med,CURE, Los Angeles, CA 90073 USA. Harbor UCLA Med Ctr, Ctr Inflammatory Bowel Dis, Torrance, CA 90509 USA. Univ Calif Los Angeles, Sch Med, Dept Biomath, Los Angeles, CA 90024 USA. Univ Manitoba, Dept Med, Winnipeg, MB, Canada. RP Chang, L (reprint author), Univ Calif Los Angeles, Dept Med & Physiol, Neuroenter Dis Program, W Los Angeles VA Med Ctr,Sch Med,CURE, Bldg 115,Room 223, Los Angeles, CA 90073 USA. EM linchang@ucla.edu NR 40 TC 121 Z9 122 U1 0 U2 2 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD OCT PY 2000 VL 47 IS 4 BP 497 EP 505 DI 10.1136/gut.47.4.497 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 358AQ UT WOS:000089535400010 PM 10986209 ER PT J AU Dore, MP Sepulveda, AR El-Zimaity, HMT Yamaoka, Y Osato, MS Kato, M Nieddu, AM Graham, DY Realdi, G AF Dore, MP Sepulveda, AR El-Zimaity, HMT Yamaoka, Y Osato, MS Kato, M Nieddu, AM Graham, DY Realdi, G TI Isolation of Helicobacter pylori from sheep: Implications for transmission to humans. SO GUT LA English DT Meeting Abstract C1 Univ Sassari, I-07100 Sassari, Italy. VA Med Ctr, Houston, TX USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD OCT PY 2000 VL 47 SU 1 BP A46 EP A46 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 368RK UT WOS:000090131200175 ER PT J AU El-Zimaity, HMT Yuksul, M Ramchatesingh, J El-Zaatari, FAK Gutierrez, O Dore, MP Graham, DY AF El-Zimaity, HMT Yuksul, M Ramchatesingh, J El-Zaatari, FAK Gutierrez, O Dore, MP Graham, DY TI Natural history of gene rearrangement in patients with malt and malt lymphoma. SO GUT LA English DT Meeting Abstract C1 VA Med Ctr, Houston, TX USA. Univ Nacl Colombia, Bogota, Colombia. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD OCT PY 2000 VL 47 SU 1 BP A71 EP A71 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 368RK UT WOS:000090131200254 ER PT J AU Graham, DY AF Graham, DY TI Effect of H-pylori status on the effectiveness of omeprazole for prevention of gastric or duodenal ulcers among chronic NSAID users. SO GUT LA English DT Meeting Abstract C1 VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD OCT PY 2000 VL 47 SU 1 BP A77 EP A77 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 368RK UT WOS:000090131200276 ER PT J AU Graham, DY Gutierrez, O Gomez, M Yamaoka, Y El-Zimaity, HMT AF Graham, DY Gutierrez, O Gomez, M Yamaoka, Y El-Zimaity, HMT TI Interleukin-1 (IL-1) is the likely mediator of reduced acid secretion associated with Corpus Gastritis. SO GUT LA English DT Meeting Abstract C1 VA Med Ctr, Houston, TX USA. Univ Nacl Colombia, Bogota, Colombia. NR 0 TC 1 Z9 1 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD OCT PY 2000 VL 47 SU 1 BP A38 EP A38 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 368RK UT WOS:000090131200147 ER PT J AU Malaty, HM Graham, DY ELKasabany, A Reddy, SG Srinivasan, SR Berenson, GS AF Malaty, HM Graham, DY ELKasabany, A Reddy, SG Srinivasan, SR Berenson, GS TI Natural history of Helicobacter pylori infection from infancy to adulthood: A 21-year follow-up cohort study. SO GUT LA English DT Meeting Abstract C1 VA Med Ctr, Houston, TX USA. Tulane Sch Publ Hlth, New Orleans, LA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD OCT PY 2000 VL 47 SU 1 BP A45 EP A45 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 368RK UT WOS:000090131200171 ER PT J AU Nurgalieva, ZZ Graham, DY Almuchambetova, R Machmudova, A Osato, MS Peacock, J Marchildon, PA Zoltek, RP Zhangabylov, A AF Nurgalieva, ZZ Graham, DY Almuchambetova, R Machmudova, A Osato, MS Peacock, J Marchildon, PA Zoltek, RP Zhangabylov, A TI Storage and transportation of blood samples from developing countries: A dry plasma collection device not affected by freeze-thaw. SO GUT LA English DT Meeting Abstract C1 VA Med Ctr, Houston, TX USA. Almaty State Med Univ, Almaty, Kazakhstan. EPI, Stony Brook, NY USA. Chemat Inc, N Webster, IN USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD OCT PY 2000 VL 47 SU 1 BP A47 EP A47 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 368RK UT WOS:000090131200180 ER PT J AU Shiotani, A Saeed, MA Yamaoka, Y El-Zimaity, HMT Osato, MS Klein, PD Graham, DY AF Shiotani, A Saeed, MA Yamaoka, Y El-Zimaity, HMT Osato, MS Klein, PD Graham, DY TI Citric acid enhanced gastric urease activity in man is unrelated to gastric emptying. SO GUT LA English DT Meeting Abstract C1 VA Med Ctr, Houston, TX USA. Meretek, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD OCT PY 2000 VL 47 SU 1 BP A120 EP A120 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 368RK UT WOS:000090131200434 ER PT J AU Fontana, RJ Perillo, R Hann, HWL Wright, T Rakela, J Bacon, BR Anschuetz, G Gardner, SD Brown, NA AF Fontana, RJ Perillo, R Hann, HWL Wright, T Rakela, J Bacon, BR Anschuetz, G Gardner, SD Brown, NA TI Determinants of survival in 133 patients with decompensated chronic hepatitis B treated with lamivudine. SO HEPATOLOGY LA English DT Meeting Abstract C1 Univ Michigan, Ann Arbor, MI 48109 USA. Oschner Clin, New Orleans, LA USA. Thomas Jefferson Univ Hosp, Philadelphia, PA 19107 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA. St Louis Sch Med, St Louis, MO USA. Glaxo Wellcome Inc, RTP, NC USA. NR 0 TC 4 Z9 4 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2000 VL 32 IS 4 MA 239 BP 221A EP 221A PN 2 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 359PZ UT WOS:000089622400235 ER PT J AU Beymer, CH Boyko, EJ Dominitz, JA AF Beymer, CH Boyko, EJ Dominitz, JA TI The association of diabetes mellitus with hepatitis C virus infection in a seroprevalence survey of the general US population 1988 to 1994. SO HEPATOLOGY LA English DT Meeting Abstract C1 Univ Washington, Sch Med, Seattle, WA 98195 USA. VA Puget Sound HCS, Seattle, WA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2000 VL 32 IS 4 MA 616 BP 313A EP 313A PN 2 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 359PZ UT WOS:000089622400603 ER PT J AU Melby, PC Ogden, GB Flores, HA Zhao, WG Geldmacher, C Biediger, NM Ahuja, SK Uranga, J Melendez, M AF Melby, PC Ogden, GB Flores, HA Zhao, WG Geldmacher, C Biediger, NM Ahuja, SK Uranga, J Melendez, M TI Identification of vaccine candidates for experimental visceral leishmaniasis by immunization with sequential fractions of a cDNA expression library SO INFECTION AND IMMUNITY LA English DT Article ID IMMUNE-RESPONSES; PLASMID DNA; ANTIGENIC DETERMINANTS; MAMMALIAN-CELLS; DONOVANI; INFECTION; MICE; IMMUNOSUPPRESSION; TRANSLATION; PROTECTION AB Visceral leishmaniasis caused by the intracellular parasite Leishmania donovani is a significant public health problem in many regions of the world. Because of its large genome and complex biology, developing a vaccine for this pathogen has proved to be a challenging task and, to date, protective recombinant vaccine candidates have not been identified. To tackle this difficult problem, we adopted a reductionist approach with the intention of identifying cDNA sequences in an L. donovani amastigote cDNA library that collectively or singly conferred protection against parasite challenge in a murine model of visceral leishmaniasis. We immunized BALB/c mice with plasmid DNA isolated and pooled from 15 cDNA sublibraries (similar to 2,000 cDNAs/sublibrary). Following systemic challenge with L. donovani, mice immunized with 6 of these 15 sublibraries showed a significantly reduced (35- to 1,000-fold) hepatic parasite burden. Because of the complexity and magnitude of the sequential fractionation-immunization-challenge approach, we restricted our attention to the two sublibraries that conferred the greatest in vivo protection. From one of these two sublibraries, we identified several groups of cDNAs that afforded protection, including a set of nine novel cDNAs and, surprisingly, a group of five cDNAs that encoded L. donovani histone proteins. At each fractionation step, the cDNA sublibraries or the smaller DNA fractions that afforded in vivo protection against the parasite also induced in vitro parasite-specific T helper 1 immune responses. Our studies demonstrate that immunization with sequential fractions of a cDNA library is a powerful strategy for identifying anti-infective vaccine candidates. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Med Serv, Audie L Murphy Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Microbiol, San Antonio, TX 78229 USA. St Marys Univ, Dept Biol Sci, San Antonio, TX USA. RP Melby, PC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, 7703 Floyd Curl Dr,Mailstop 7881, San Antonio, TX 78229 USA. NR 34 TC 71 Z9 74 U1 0 U2 2 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD OCT PY 2000 VL 68 IS 10 BP 5595 EP 5602 DI 10.1128/IAI.68.10.5595-5602.2000 PG 8 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 355QE UT WOS:000089395700018 PM 10992459 ER PT J AU Cheng, YL Shek, CC Tsang, DNC Li, CS Lentino, JR Daugirdas, JT Kjellstrand, CM Ing, TS AF Cheng, YL Shek, CC Tsang, DNC Li, CS Lentino, JR Daugirdas, JT Kjellstrand, CM Ing, TS TI Stability of urea and creatinine in spent hemodialysate SO INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS LA English DT Article DE urea; creatinine; dialysate ID PARTIAL DIALYSATE COLLECTION; SOLUTE REMOVAL INDEX; WATER; QUANTIFICATION; CONTAMINATION; MULTICENTER; ADEQUACY; MONITOR AB Urea and creatinine levels in spent hemodialysates showed only small declines in spite of incubation at 37 degrees C for 36 hours, in the determination of dialysate-side solute removal, it would seem prudent to keep spent dialysate cold during collection to retard bacterial breakdown of these waste products. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Renal & Hypertens Sect, Dept Med, Hines, IL 60141 USA. Queen Elizabeth Hosp, Dept Med, Hong Kong, Hong Kong, Peoples R China. Queen Elizabeth Hosp, Dept Pathol, Hong Kong, Hong Kong, Peoples R China. Loyola Univ, Stritch Sch Med, Maywood, IL 60153 USA. RP Ing, TS (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Renal & Hypertens Sect, Dept Med, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. NR 32 TC 2 Z9 2 U1 0 U2 1 PU WICHTIG EDITORE PI MILAN PA 72/74 VIA FRIULI, 20135 MILAN, ITALY SN 0391-3988 J9 INT J ARTIF ORGANS JI Int. J. Artif. Organs PD OCT PY 2000 VL 23 IS 10 BP 670 EP 674 PG 5 WC Engineering, Biomedical; Transplantation SC Engineering; Transplantation GA 370ML UT WOS:000165126800003 PM 11075896 ER PT J AU Li-Yu, J Schumacher, HR Gratwick, G AF Li-Yu, J Schumacher, HR Gratwick, G TI Invasive tophaceous pseudogout in the temporomandibular joint: Misdiagnosis as tumor - Case report and review of the literature SO JCR-JOURNAL OF CLINICAL RHEUMATOLOGY LA English DT Review DE tophaceous pseudogout; temporomandibular joint ID DIHYDRATE DEPOSITION DISEASE; CRYSTAL DEPOSITION; PYROPHOSPHATE; CHONDROCALCINOSIS; PSEUDOTUMOR; ARTHROPATHY; CPPD AB We report a case of focal calcium pyrophosphate dihydrate (CPPD) arthropathy in a 72-year-old, white woman that occurred in the temporomandibular joint (TMJ), a relatively unusual location for CPPD crystals. The patient underwent surgical exploration and radiation therapy because of histologic interpretation of an initial biopsy specimen as showing metastatic poorly differentiated carcinoma. Further evaluation of the specimen revealed the presence of positively birefringent crystals under compensated polarizing light microscopic examination. Previously reported cases of CPPD affecting the TMJ have also shown that this may mimic neoplastic or infectious conditions. Tophaceous pseudogout at the TMJ is a surprisingly common complication of CPPD deposition disease. As in our patient, it can occur without, known CPPD at other sites. C1 Univ Penn, Sch Med, Rheumatol Sect, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Arthritis Immunol Ctr, Philadelphia, PA 19104 USA. Block & Gratwick, Bangor, ME USA. NR 23 TC 3 Z9 3 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1076-1608 J9 JCR-J CLIN RHEUMATOL JI JCR-J. Clin. Rheumatol. PD OCT PY 2000 VL 6 IS 5 BP 272 EP 277 DI 10.1097/00124743-200010000-00007 PG 6 WC Rheumatology SC Rheumatology GA 363HD UT WOS:000089828800009 PM 19078485 ER PT J AU Xie, AL Skatrud, JB Crabtree, DC Puleo, DS Goodman, BM Morgan, BJ AF Xie, AL Skatrud, JB Crabtree, DC Puleo, DS Goodman, BM Morgan, BJ TI Neurocirculatory consequences of intermittent asphyxia in humans SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE sympathetic nervous system; hypoxia; hypercapnia ID SYMPATHETIC ACTIVITY; NERVE RESPONSES; BLOOD-PRESSURE; SLEEP-APNEA; NREM SLEEP; HYPOXIA; VENTILATION; HYPERCAPNIA; ACTIVATION; ELEVATION AB We examined the neurocirculatory and ventilatory responses to intermittent asphyxia (arterial O-2 saturation = 79-85%, end-tidal Pco(2) = 3-5 Torr above eupnea) in seven healthy humans during wakefulness. The intermittent asphyxia intervention consisted of 20-s asphyxic exposures alternating with 40-s periods of room-air breathing for a total of 20 min. Minute ventilation increased during the intermittent asphyxia period (14.2 +/-. 2.0 l/min in the final 5 min of asphyxia vs. 7.5 +/- 0.4 l/min in baseline) but returned to the baseline level within 2 min after completion of the series of asphyxic exposures. Muscle sympathetic nerve activity increased progressively, reaching 175 +/- 12% of baseline in the final 5 min of the intervention. Unlike ventilation, sympathetic activity remained elevated for at least 20 min after removal of the chemical stimuli (150 +/- 10% of baseline in the last 5 min of the recovery period). Intermittent asphyxia caused a small, but statistically significant, increase in heart rate (64 +/- 4 beats/min in the final 5 min of asphyxia vs. 61 +/- 4 beats/min in baseline); however, this increase was not sustained after the return to room-air breathing. These data demonstrate that relatively short-term exposure to intermittent asphyxia causes sympathetic activation that persists after removal of the chemical stimuli. This carryover effect provides a potential mechanism whereby intermittent asphyxia during sleep could lead to chronic sympathetic activation in patients with sleep apnea syndrome. C1 William S Middleton Mem Vet Hosp, Pulm Physiol Lab, Dept Med, Madison, WI 53705 USA. William S Middleton Mem Vet Hosp, Dept Surg, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Madison, WI 53705 USA. Univ Wisconsin, Dept Surg, Madison, WI 53705 USA. RP Xie, AL (reprint author), William S Middleton Mem Vet Hosp, Pulm Physiol Lab, Dept Med, 2500 Overlook Terrace, Madison, WI 53705 USA. NR 25 TC 65 Z9 68 U1 0 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD OCT PY 2000 VL 89 IS 4 BP 1333 EP 1339 PG 7 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 362AE UT WOS:000089755800011 PM 11007566 ER PT J AU Kogai, T Curcio, F Hyman, S Cornford, EM Brent, GA Hershman, JM AF Kogai, T Curcio, F Hyman, S Cornford, EM Brent, GA Hershman, JM TI Induction of follicle formation in long-term cultured normal human thyroid cells treated with thyrotropin stimulates iodide uptake but not sodium/iodide symporter messenger RNA and protein expression SO JOURNAL OF ENDOCRINOLOGY LA English DT Article ID APICAL PLASMA-MEMBRANE; NA+/I SYMPORTER; FRTL-5 CELLS; CONGENITAL HYPOTHYROIDISM; HORMONE SYNTHESIS; EPITHELIAL-CELLS; GENE-EXPRESSION; COLLAGEN GEL; TRANSPORT; ADENOSINE-3',5'-MONOPHOSPHATE AB Iodide uptake by the sodium/iodide symporter (NIS) in thyrocytes is essential for thyroid hormone production. Reduced NIS activity has been reported in thyroid diseases, including thyroid cancer and congenital hypothyroidism. The study of iodide uptake in thyrocytes has been limited by the availability of appropriate in vitro models, A new culture technique was recently developed that allows normal human thyroid primary culture cells to grow as monolayer cells and express differentiated functions for more than 3 months. We used this technique to study the effect of follicle formation and TSH on iodide uptake in these cells. Iodide uptake by the cells grown in monolayer was very low. Follicle formation was induced from monolayer cells, and electron micrographs demonstrated cell polarity in the follicles. No significant increase in iodide uptake was observed after TSH treatment of cells in monolayer or when follicle formation was induced without TSH. TSH stimulation of follicles, however, significantly increased iodide uptake (similar to4.4-fold; P<0.001). Compared with iodide uptake in monolayers, the combination of follicle formation and TSH treatment stimulated iodide uptake synergistically to 12.0-fold (P<0.001). NIS messenger RNA (mRNA) and protein levels were almost the same in both monolayer cells and follicles. TSH treatment of monolayers and follicles produced significant (P<0.05) stimulation of mRNA (4.8- and 4.3-fold respectively) and protein (similar to6.8- and 4.9-fold respectively). TSH stimulated NIS protein levels in both monolayer and follicles, however, stimulation of functional iodide uptake was only seen with TSH stimulation of follicles. The function of NIS may involve post-transcriptional events, such as intracellular sorting, membrane localization of NIS or another NIS regulatory factor. Polarized functions, such as iodide efflux into follicular lumina, may also contribute to the increased iodide concentration after follicle formation. C1 W Los Angeles VA Med Ctr, Div Endocrinol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90073 USA. Univ Udine, Dipartimento Patol & Med Sperimentale & Clin, I-33100 Udine, Italy. Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. W Los Angeles VA Med Ctr, SW Reg VA Epilepsy Ctr, Res Serv, Los Angeles, CA 90073 USA. W Los Angeles VA Med Ctr, SW Reg VA Epilepsy Ctr, Neurol Serv, Los Angeles, CA 90073 USA. RP Hershman, JM (reprint author), W Los Angeles VA Med Ctr, Div Endocrinol & Metab 111D, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Curcio, Francesco/K-4669-2014 FU NIDDK NIH HHS [DK 43714]; NINDS NIH HHS [NS 37360] NR 42 TC 45 Z9 50 U1 0 U2 4 PU SOC ENDOCRINOLOGY PI BRISTOL PA 17/18 THE COURTYARD, WOODLANDS, BRADLEY STOKE, BRISTOL BS32 4NQ, ENGLAND SN 0022-0795 J9 J ENDOCRINOL JI J. Endocrinol. PD OCT PY 2000 VL 167 IS 1 BP 125 EP 135 DI 10.1677/joe.0.1670125 PG 11 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 406HR UT WOS:000167209300014 PM 11018760 ER PT J AU Sutton, PR Harley, JD Jacobson, AF Lipsky, BA AF Sutton, PR Harley, JD Jacobson, AF Lipsky, BA TI Diagnosing osteomyelitis with percutaneous bone biopsy in patients with diabetes and foot ulcerations. SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Meeting Abstract C1 VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Dept Radiol, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Dept Nucl Med, Seattle, WA USA. NR 0 TC 2 Z9 2 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD OCT PY 2000 VL 15 SU 2 BP 6 EP 6 DI 10.1046/j.1525-1497.2000.15200-25.x PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 374CK UT WOS:000165326700026 ER PT J AU Gazitt, Y Callander, N Freytes, CO Shaughnessy, P Liu, Q Tsai, TW Devore, P AF Gazitt, Y Callander, N Freytes, CO Shaughnessy, P Liu, Q Tsai, TW Devore, P TI Peripheral blood stem cell mobilization with cyclophosphamide in combination with G-CSF, GM-CSF, or sequential GM-CSF/G-CSF in non-Hodgkin's lymphoma patients: A randomized prospective study SO JOURNAL OF HEMATOTHERAPY & STEM CELL RESEARCH LA English DT Article ID COLONY-STIMULATING FACTOR; HEMATOPOIETIC PROGENITOR CELLS; HIGH-DOSE CHEMOTHERAPY; CLONAL MYELOMA CELLS; MULTIPLE-MYELOMA; ENGRAFTMENT KINETICS; MALIGNANT-LYMPHOMA; SOLID TUMORS; BONE-MARROW; GRANULOCYTE AB We designed a randomized, prospective three-arm mobilization study to determine the kinetics of peripheral blood stem cell (PBSC) mobilization in 60 non-Hodgkin's lymphoma (NHL) patients primed with cyclophosphamide (CTX) in combination with granulocyte colony-stimulating factor (G-CSF) (arm A), granulocyte-macrophage (GM)-CSF (arm B) or GM-CSF/G-CSF (arm C). We also compared mobilization and transplant-related toxicities, pre- and post-transplant support and the probability of survival among the three arms. To date, 35 patients have been enrolled in the study; 13 patients have been enrolled in arm A, 10 patients in arm B, and 13 patients in arm C. Successful collection of the target of greater than or equal to 2x10(6) CD34(+) cells/kg in one to four apheresis collections was 10/13, 6/10, and 7/12 in arms A, B, and C, respectively. The differences between arms were not statistically significant. The median time to achieve the target CD34(+) cells in patients who successfully mobilized the target CD34(+) cells was 3 days, 2 days, and 1 day, in patients in arms A, B, and C, respectively. The time for neutrophil engraftment was 11, 10, and 10 days in arms A, B, and C, respectively. The time for platelet engraftment was 11 days for patients in all arms of the study. Most importantly, no significant differences were observed among the three arms in the duration of neutropenic fever, the extent of mucositis, diarrhea, and nausea/vomiting, or in the number of units of platelets or red cells transfused after transplantation. Risk factors associated with poor mobilization were greater than or equal to3 regimens of chemotherapy prior to mobilization, older age, and disease histology (follicular versus diffuse). Therefore, we conclude that the type of growth factor used for mobilization did not play a major role in the outcome of mobilization and recommend mobilizing NHL patients before they receive multiple regimens of chemotherapy. C1 Univ Texas, Hlth Sci Ctr, Audie L Murphy Mem Vet Hosp, San Antonio, TX 78284 USA. Wilford Hall USAF Med Ctr, San Antonio, TX 78284 USA. RP Gazitt, Y (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med Hematol, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. NR 36 TC 31 Z9 31 U1 0 U2 1 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1525-8165 J9 J HEMATOTH STEM CELL JI J. Hematother. Stem Cell Res. PD OCT PY 2000 VL 9 IS 5 BP 737 EP 748 DI 10.1089/15258160050196786 PG 12 WC Hematology; Medicine, Research & Experimental; Transplantation SC Hematology; Research & Experimental Medicine; Transplantation GA 375ZE UT WOS:000165432700018 PM 11091498 ER PT J AU Ferbas, J Giorgi, JV Amini, S Grovit-Ferbas, K Wiley, DJ Detels, R Plaeger, S AF Ferbas, J Giorgi, JV Amini, S Grovit-Ferbas, K Wiley, DJ Detels, R Plaeger, S TI Antigen-specific production of RANTES, macrophage inflammatory protein (MIP)1 alpha, and MIP-1 beta in vitro is a correlate of reduced human immunodeficiency virus burden in vivo SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT International Meeting of the Institute-of-Human-Virology CY AUG 28-SEP 02, 1999 CL BALTIMORE, MARYLAND SP Inst Human Virol ID C-C CHEMOKINES; BETA-CHEMOKINES; HIV-INFECTION; DISEASE PROGRESSION; IN-VITRO; EXPRESSION; INFECTABILITY; INDIVIDUALS; CD4(+); CELLS AB RANTES (regulated on activation, normal T expressed and secreted), macrophage inflammatory protein (MIP)-1 alpha, and MIP-1 beta are human immunodeficiency virus (HIV) suppressor factors by virtue of their ability to compete with HIV for access to cell surface R5. Their ability to block HIV infection in vitro is unequivocal; however, their role as HIV suppressor factors in vivo is not firmly established. We therefore conducted a study to test the hypothesis that production of these factors in vitro was a correlate of decreased virus burden in vivo. Moreover, we asked whether higher beta chemokine production could be demonstrated with cells from people who are R5D32 heterozygotes, compared with people who are R5 wild-type homozygotes. Our data support the thesis that RANTES, MIP-1 alpha, and MIP-1 beta production is associated with decreased in vivo virus load. Moreover, enhanced production of these facto rs may be explained in part by the genetic background of the host. C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Pediat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Epidemiol, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Ferbas, J (reprint author), Amgen, 1 Amgen Ctr Dr, Thousand Oaks, CA 91320 USA. FU NIAID NIH HHS [AI-37613-04] NR 15 TC 31 Z9 32 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD OCT PY 2000 VL 182 IS 4 BP 1247 EP 1250 DI 10.1086/315849 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 361FJ UT WOS:000089712100034 PM 10979927 ER PT J AU Hong, W Morimatsu, S Goto, T Sachs, G Scott, DR Weeks, DL Kohno, T Morita, C Nakano, T Fujioka, Y Sano, K AF Hong, W Morimatsu, S Goto, T Sachs, G Scott, DR Weeks, DL Kohno, T Morita, C Nakano, T Fujioka, Y Sano, K TI Contrast-enhanced immunoelectron microscopy for Helicobacter pylori SO JOURNAL OF MICROBIOLOGICAL METHODS LA English DT Article DE alcian blue; contrast enhancement; Helicobacter pylori; immunoelectron microscopy ID HEAT-SHOCK PROTEIN; LOCALIZATION; UREASE; VIRUS AB Since a method of contrast enhancement for immunoelectron microscopy has not been available in bacteriology, the morphological localization of proteins of Helicobacter pylori is not well known. In this report, we established a method of contrast enhancement in immunoelectron microscopy in this organism. Immunostained ultrathin sections are stained with a mixture of alcian blue and osmium tetroxide prior to staining with uranyl acetate. This method of staining provided good contrast enhancement of the bacterial cell wall and membrane without any loss of immunolabeled gold particles on the ultrathin section. (C) 2000 Elsevier Science B.V. All rights reserved. C1 Osaka Med Coll, Dept Microbiol, Takatsuki, Osaka 5698686, Japan. Univ Calif Los Angeles, Dept Physiol & Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Sano, K (reprint author), Osaka Med Coll, Dept Microbiol, 2-7 Daigaku Machi, Takatsuki, Osaka 5698686, Japan. NR 17 TC 10 Z9 11 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-7012 J9 J MICROBIOL METH JI J. Microbiol. Methods PD OCT PY 2000 VL 42 IS 2 BP 121 EP 127 DI 10.1016/S0167-7012(00)00165-2 PG 7 WC Biochemical Research Methods; Microbiology SC Biochemistry & Molecular Biology; Microbiology GA 362UU UT WOS:000089797300002 PM 11018268 ER PT J AU Nagayama, T Lan, J Henshall, DC Chen, DX O'Horo, C Simon, RP Chen, J AF Nagayama, T Lan, J Henshall, DC Chen, DX O'Horo, C Simon, RP Chen, J TI Induction of oxidative DNA damage in the peri-infarct region after permanent focal cerebral ischemia SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE focal cerebral ischemia; DNA fragmentation; apurinic/apyrimidinic abasic sites; 8-hydroxyl-2 '-deoxyguanosine ID PROGRAMMED CELL-DEATH; ABASIC SITES; TIRILAZAD MESYLATE; RADICAL FORMATION; ARTERY OCCLUSION; STRAND BREAKS; NITRIC-OXIDE; BRAIN-DAMAGE; RAT-BRAIN; APOPTOSIS AB To address the role of oxidative DNA damage in focal cerebral ischemia lacking reperfusion, we investigated DNA base and strand damage in a rat model of permanent middle cerebral artery occlusion (MCAO), Contents of 8-hydroxyl-2'-deoxyguanosine (8-OHdG) and apurinic/apyrimidinic abasic sites (AP sites), hallmarks of oxidative DNA damage, were quantitatively measured in nuclear DNA extracts from brains obtained 4-72 h after MCAO, DNA single- and double-strand breaks were detected on coronal brain sections using in situ DNA polymerase I-mediated biotin-dATP nick-translation (PANT) and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL), respectively, Levels of 8-OHdG and AP sites were markedly elevated 16-72 h following MCAO in the frontal cortex, representing the peri-infarct region, but levels did not significantly change within the ischemic core regions of the caudate-putamen and parietal cortex. PANT- and TUNEL-positive cells began to be detectable 4-8 h following MCAO in the caudate-putamen and parietal cortex and reached maximal levels at 72 h. PANT- and TUNEL-positive cells were also detected 16-72 h after MCAO in the lateral frontal cortex within the infarct border, where many cells also showed colocalization of DNA single-strand breaks and DNA fragmentation, In contrast, levels of PANT-positive cells alone were transiently increased (16 h after MCAO) in the medial frontal cortex, an area distant from the infarct zone. These data suggest that within periinfarct brain regions, oxidative injury to nuclear DNA in the form of base and strand damage may be a significant and contributory cause of secondary expansion of brain damage following permanent focal ischemia. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Inst Neurodegenerat Disorders, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. Legacy Clin Res & Technol Ctr, Portland, OR USA. RP Chen, J (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, S-507,Biomed Sci Tower, Pittsburgh, PA 15213 USA. RI Henshall, David/C-3364-2012 FU NINDS NIH HHS [NS 38560, NS 25965, NS 36736] NR 59 TC 98 Z9 108 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD OCT PY 2000 VL 75 IS 4 BP 1716 EP 1728 DI 10.1046/j.1471-4159.2000.0751716.x PG 13 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 353EZ UT WOS:000089263000043 PM 10987855 ER PT J AU Graham, SH Chen, J Clark, RSB AF Graham, SH Chen, J Clark, RSB TI Bcl-2 family gene products in cerebral ischemia and traumatic brain injury SO JOURNAL OF NEUROTRAUMA LA English DT Article DE apoptosis; bax; bcl-2; bcl-w; bcl-x; bid; cerebral ischemia; programmed cell death; traumatic brain injury ID PROGRAMMED CELL-DEATH; PERMEABILITY TRANSITION PORE; CYTOCHROME-C RELEASE; PROTOONCOGENE BCL-2; TRANSGENIC MICE; RAT-BRAIN; ISOLATED-MITOCHONDRIA; SEQUENCE SIMILARITY; GLOBAL-ISCHEMIA; FOCAL ISCHEMIA AB The proto-oncogene bcl-2 plays a key role in regulating programmed cell death in neurons, The present review discusses the mechanisms by which bcl-2 family genes regulate programmed cell death, and their role in controlling cell death in cerebral ischemia and traumatic brain, Expression of several bcl-2 family members is altered in brain tissues after ischemia and trauma, suggesting that bcl-2 family genes could play a role in determining the fate of injured neurons. Furthermore, alteration of expression of bcl-2 family genes using transgenic approaches, viral vectors, or anti-sense oligonucleotides modifies neuronal cell death and neurological outcome after injury, These data suggest that the activity of bcl-2 family gene products participates in determining cellular and neurologic outcomes in ischemia and trauma, Strategies that either mimic the death-suppressor effects or inhibit the death-promoter effects of bcl-2 family gene products may improve outcome after ischemia and trauma. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Anesthesiol & Crit Care Med, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Pediat, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Hlth Ctr, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Graham, SH (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, 526 S BST, Pittsburgh, PA 15213 USA. FU NINDS NIH HHS [P50 NS3031, K08 NS01946, P01 NS35965] NR 93 TC 67 Z9 99 U1 1 U2 3 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 0897-7151 J9 J NEUROTRAUM JI J. Neurotrauma PD OCT PY 2000 VL 17 IS 10 BP 831 EP 841 DI 10.1089/neu.2000.17.831 PG 11 WC Critical Care Medicine; Clinical Neurology; Neurosciences SC General & Internal Medicine; Neurosciences & Neurology GA 364LR UT WOS:000089894300004 PM 11063051 ER PT J AU Haigh, PI Hansen, NM Giuliano, AE Edwards, GK Ye, W Glass, EC AF Haigh, PI Hansen, NM Giuliano, AE Edwards, GK Ye, W Glass, EC TI Factors affecting sentinel node localization during preoperative breast lymphoscintigraphy SO JOURNAL OF NUCLEAR MEDICINE LA English DT Article DE breast cancer; lymphoscintigraphy; sentinel node ID GAMMA-PROBE; LYMPH-NODE; CANCER; BIOPSY; LYMPHADENECTOMY; FEASIBILITY; RESECTION; MELANOMA AB Variable success rates for identifying axillary (AX) sentinel nodes in breast cancer patients using preoperative lymphoscintigraphy have been reported. We evaluated the effects of age, weight, breast size, method of biopsy, interval after biopsy, and imaging view on the success of sentinel node identification and on the kinetics of radiopharmaceutical migration. Methods: Preoperative breast lymphoscintigraphy was performed in consecutive breast cancer patients from February 1998 to December 1998. The ipsilateral shoulder was elevated on a foam wedge and the arm was abducted and elevated overhead. Imaging using this modified oblique view of the axilla (MOVA) started immediately after peritumoral injection of Millipore-filtered Tc-99m-sulfur colloid and continued until AX sentinel nodes were identified. Anterior views were obtained after MOVA. AX, internal mammary (IM), and clavicular (CL) basins were monitored in all patients. MOVA was compared with the anterior view for sentinel node identification, Age, weight, breast size, method of biopsy, interval after biopsy, and primary tumor location were evaluated for their effects on sentinel node localization and transit times from injection to arrival at the sentinel nodes. Results: Seventy-six lymphoscintigrams were obtained for 75 patients. AX sentinel nodes were revealed in 75 (99%) cases. IM or CL sentinel nodes were found in 19 (25%) cases and were not related to tumor location; exclusive IM drainage was present in 1 (1%) case. Identification of AX sentinel nodes was equivalent with MOVA and anterior views in 18 (24%) patients, was better with MOVA in 20 (26%) patients, and was accomplished only with MOVA in 38 (50%) patients. Median transit time was 17.5 min (range, 1 min to 18 h) after injection, and larger breast size was associated with increased transit time. No effect of age, weight, biopsy method, interval from biopsy, or tumor location on transit time was found. Conclusion: Use of MOVA can improve identification of AX sentinel nodes. Although AX drainage is the predominant pattern, a tumor in any portion of the breast can drain to IM sentinel nodes. Transit time was influenced by breast size. Overall short arrival times with this technique allow sentinel lymph node dissection to be performed on the same day as lymphoscintigraphy. C1 Joyce Eisenberg Keefer Breast Ctr, Santa Monica, CA USA. St Johns Hlth Ctr, John Wayned Canc Inst, Div Surg Oncol, Santa Monica, CA USA. John Wayne Canc Inst, Stat Coordinating Unit, Santa Monica, CA USA. St Johns Hlth Ctr, Dept Nucl Med, Santa Monica, CA USA. RP Glass, EC (reprint author), W Los Angeles Vet Affairs Med Ctr, Nucl Med Sect 115, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 19 TC 52 Z9 53 U1 0 U2 0 PU SOC NUCLEAR MEDICINE INC PI RESTON PA 1850 SAMUEL MORSE DR, RESTON, VA 20190-5316 USA SN 0161-5505 J9 J NUCL MED JI J. Nucl. Med. PD OCT PY 2000 VL 41 IS 10 BP 1682 EP 1688 PG 7 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 364JJ UT WOS:000089889000019 PM 11037998 ER PT J AU Canalejo, A Almaden, Y Torregrosa, V Gomez-Villamandos, JC Ramos, B Campistol, JM Felsenfeld, AJ Rodriguez, M AF Canalejo, A Almaden, Y Torregrosa, V Gomez-Villamandos, JC Ramos, B Campistol, JM Felsenfeld, AJ Rodriguez, M TI The in vitro effect of calcitriol on parathyroid cell proliferation and apoptosis SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID CHRONIC-RENAL-FAILURE; VITAMIN-D METABOLITES; SECONDARY HYPERPARATHYROIDISM; INTRAVENOUS CALCITRIOL; HEMODIALYSIS-PATIENTS; GLANDS; HYPERPLASIA; HORMONE; CALCIUM; 1,25(OH)2D3 AB Calcitriol treatment is used to reduce parathyroid hormone levels in azotemic patients with secondary hyperparathyroidism (HPT). Whether long-term calcitriol administration reduces parathyroid gland size in patients with severe secondary hyperparathyroidism is not clear. The aim of the study was to evaluate in vitro the effect of calcitriol on parathyroid cell proliferation and apoptosis in normal parathyroid glands and in adenomatous and hyperplastic human parathyroid glands. Freshly harvested parathyroid glands from normal dogs and hyperplastic and adenomatous glands from patients with secondary (2 degrees) and primary (1 degrees) HPT undergoing parathyroidectomy were studied. Flow cytometry was used to quantify the cell cycle and apoptosis of parathyroid cells. Apoptosis was also evaluated by DNA electrophoresis and light and electron microscopy. In normal dog parathyroid glands, culture with calcitriol (10(-10) to 10(-7) M) for 24 h produced a dose-dependent inhibitory effect on the progression of cells into the cell cycle and into apoptosis. When glands from patients with 2 degrees HPT were cultured for 24 h, only high calcitriol concentrations (10-7 M) inhibited the progression through the cell cycle and the induction of apoptosis. In parathyroid adenomas (1 degrees HPT), even a high concentration of calcitriol (10(-7) M) had no significant effect on the cell cycle or apoptosis. The present study shows that in vitro, calcitriol inhibits in a dose-dependent manner in normal parathyroid glands both parathyroid cell proliferation and apoptosis. However, in secondary hyperplasia, only high concentrations of calcitriol inhibited cell proliferation and apoptosis. In 1 degrees HPT, even high concentrations of calcitriol had no effect. Because calcitriol simultaneously inhibits both cell proliferation and apoptosis, a reduction in the parathyroid gland mass may not occur as a direct effect of calcitriol treatment. C1 Univ Cordoba, Reina Sofia Hosp, Res Unit, E-14071 Cordoba, Spain. Univ Cordoba, Reina Sofia Hosp, Serv Nephrol, E-14071 Cordoba, Spain. Hosp Clin Barcelona, Serv Nephrol, Barcelona, Spain. Univ Cordoba, Fac Vet, Dept Pathol, E-14071 Cordoba, Spain. Carlos Haya Hosp, Serv Nephrol, Malaga, Spain. W Los Angeles VA Med Ctr, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. RP Rodriguez, M (reprint author), Hosp Reina Sofia, Unidad Invest, Avda Menendez Pidal S-N, Cordoba 14004, Spain. RI Rodriguez, teresa/H-5452-2011; Canalejo, Antonio/L-8407-2014 OI Canalejo, Antonio/0000-0003-2098-8960 NR 34 TC 37 Z9 39 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD OCT PY 2000 VL 11 IS 10 BP 1865 EP 1872 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 358DB UT WOS:000089541000010 PM 11004217 ER PT J AU Katz, MS AF Katz, MS TI Geriatrics grand rounds: Eve's rib, or a revisionist view of osteoporosis in men SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID BONE-MINERAL DENSITY; ESTROGEN-RECEPTOR GENE; SEX STEROID-LEVELS; ELDERLY MEN; AROMATASE DEFICIENCY; POSTMENOPAUSAL WOMEN; BINDING GLOBULIN; HIP FRACTURE; HEALTHY-MEN; OLDER MEN AB It is widely accepted that estrogen withdrawal following menopause predisposes women to accelerated bone loss and increased risk of developing osteoporosis. Although osteoporosis is a significant public health problem for aging men as well as women, the cause of osteoporosis in men remains largely unknown. A substantial number of men with osteoporosis present with bone loss secondary to conditions associated with reduced gonadal steroid hormone levels. Although hypogonadism is related to bone loss in men, and androgen levels decline with age in men, it is not at all clear that reduced androgen levels are related to bone loss in older men. What, then, is the role of gonadal steroids in osteoporosis in men? This review focuses on recent research-including clinical investigations of men with genetic disorders of estrogen action, basic biomedical studies of estrogen receptor "knockout" mice, and population-based comparisons of bone density with gonadal steroids in older men-leading to the surprising conclusion that estrogen plays a vital role in maintenance of bone in men as well as in women. Possible mechanisms whereby reduced estrogen levels might result in bone loss in both sexes are also reviewed, as are potential therapeutic implications of a role for estrogen in osteoporosis in men. C1 S Texas Vet Hlth Care Syst, Geriatr Res Educ & Clin Ctr 182, Audie L Murphy Div, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, Div Geriatr & Gerontol, San Antonio, TX 78284 USA. RP Katz, MS (reprint author), S Texas Vet Hlth Care Syst, Geriatr Res Educ & Clin Ctr 182, Audie L Murphy Div, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. NR 59 TC 5 Z9 5 U1 1 U2 1 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD OCT PY 2000 VL 55 IS 10 BP M560 EP M569 PG 10 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 373WF UT WOS:000165312500010 PM 11034228 ER PT J AU Bartzokis, G Beckson, M Lu, PH Edwards, N Rapoport, R Wiseman, E Bridge, P AF Bartzokis, G Beckson, M Lu, PH Edwards, N Rapoport, R Wiseman, E Bridge, P TI Increased CSF volumes are associated with diminished subjective responses to cocaine infusion SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE cocaine; euphoria; subjective; CSF; ventricles; cortex; frontal ID MAGNETIC-RESONANCE; GRAY-MATTER; BRAIN; ABUSERS; LOBE; HIPPOCAMPUS; DEPENDENCE; PERFUSION; DOPAMINE; USERS AB We evaluated the hypothesis that ventricular and cortical CSF volume increases are associated with reductions in the magnitude of euphoric effects produced by intravenous IV cocaine infusion in cocaine dependent (CD) individuals. Eleven CD patients participating in a cocaine-infusion study and eleven control subjects underwent magnetic resonance imaging (MRI). Two CSF regions of interest (lateral ventricles and frontal cortex CSF) and two comparison regions (third ventricle and posterior cortex CSF) were measured. Self-reported ratings of the intensify of euphoric response ("high") were obtained from the CD subjects at 3, 20, and 30 minutes after IV administration of cocaine. A significant negative correlation was observed between the volume of the lateral ventricles and subjective ratings of the "high" experienced at 3 minutes, but riot at 20 and 30 minutes after cocaine infusion. In contrast, a significant negative correlation between frontal cortex CSF volume and the intensity of euphoric response was observed at 30 minutes after IV cocaine. No significant associations were observed between the volumes of the two comparison regions and ally subjective ratings of "high." No significant volume differences were observed between the CD and control groups in any region. The results suggest larger lateral ventricular volumes are associated with a decrease in immediate euphoria while larger frontal cortex CSF volumes are associated with a decrease in the duration? of the euphoria induced by cocaine infusion. The age-related brain volume reductions underlying the volume increase in these two CSF spaces may be the neurobiological basis of the age-related reduction in the rates of addiction. (C) 2000 American College of Neuropsychopharmacology. Published by Elsevier Science Inc. C1 Cent Arkansas Vet Healthcare Syst, Mental Hlth Serv Line, N Little Rock, AR 72114 USA. Univ Arkansas Med Sci, Dept Psychiat, Little Rock, AR 72205 USA. Greater Los Angeles VA Healthcare Syst, W Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90074 USA. NIDA, Medicat Dev Div, Rockville, MD 20857 USA. RP Bartzokis, G (reprint author), Cent Arkansas Vet Healthcare Syst, Mental Hlth Serv Line, 2200 Ft Roots Dr,Bldg 170,116A-NLR, N Little Rock, AR 72114 USA. RI Bartzokis, George/K-2409-2013 FU NIDA NIH HHS [1YO1 DA 50038] NR 27 TC 6 Z9 7 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD OCT PY 2000 VL 23 IS 4 BP 468 EP 473 DI 10.1016/S0893-133X(00)00122-6 PG 6 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 355KV UT WOS:000089385600013 PM 10989274 ER PT J AU Wisse, BE Frayo, RS Cummings, DE AF Wisse, BE Frayo, RS Cummings, DE TI A central melanocortin antagonist reverses cancer anorexia in rats SO OBESITY RESEARCH LA English DT Meeting Abstract C1 Univ Washington, Div Metab Endocrinol & Nutr, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU NORTH AMER ASSOC STUDY OBESITY PI ROCHESTER PA C/O DR MICHAEL JENSEN, MAYO MEDICAL CENTER, MAYO CLIN 200 FIRST ST, SW, ROCHESTER, MN 55905 USA SN 1071-7323 J9 OBES RES JI Obes. Res. PD OCT PY 2000 VL 8 SU 1 MA O159 BP 53S EP 53S PG 1 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 364DE UT WOS:000089876100210 ER PT J AU Malone, DC Carter, BL Billups, SJ Valuck, RJ Barnette, DJ Sintek, CD Okano, GJ Ellis, S Covey, D Mason, B Jue, S Carmichael, J Guthrie, K Sloboda, L Dombrowski, R Geraets, DR Amato, MG AF Malone, DC Carter, BL Billups, SJ Valuck, RJ Barnette, DJ Sintek, CD Okano, GJ Ellis, S Covey, D Mason, B Jue, S Carmichael, J Guthrie, K Sloboda, L Dombrowski, R Geraets, DR Amato, MG TI An economic analysis of a randomized, controlled, multicenter study of clinical pharmacist interventions for high-risk veterans: The IMPROVE study SO PHARMACOTHERAPY LA English DT Article; Proceedings Paper CT Spring Meeting of the American-College-of-Clinical-Pharmacy CY APR 11-14, 1999 CL ORLANDO, FLORIDA SP Amer Coll Clin Pharm ID PHARMACEUTICAL CARE; AFFAIRS; EVENTS AB Study Objective. To determine if clinical pharmacists could affect economic resource use and humanistic outcomes in an ambulatory high-risk population. Design. Prospective, randomized, controlled study. Setting. Nine Veterans Affairs medical centers. Patients. Patients who were at high risk for medication-related problems. Intervention. Patients were randomized to usual medical care with input from a clinical pharmacist (intervention group) or just usual medical care (control group). Measurements and Main Results. Of 1054 patients enrolled, 523 were randomized to the intervention group and 531 to the control group. The number of clinic visits increased in the intervention group (p=0.003), but there was no difference in clinic costs. Mean increases in total health care costs were $1020 for the intervention group and $1313 for the control group (p=0.06). Conclusion. including the cost of pharmacist interventions, overall health care expenditures were similar for patients randomized to see a clinical pharmacist versus usual medical care. C1 Univ Colorado, Hlth Sci Ctr, Sch Pharm, Denver, CO 80262 USA. Denver VA Med Ctr, Denver, CO USA. James A Haley Vet Hosp, Tampa, FL 33612 USA. Boise VA Med Ctr, Boise, ID USA. Reno VA Med Ctr, Reno, NV USA. John L McClellan Mem Vet Hosp, Little Rock, AR USA. VA Chicago Hlth Care Syst, Lakeside Div, Chicago, IL USA. Baltimore VA Med Ctr, Baltimore, MD USA. Iowa City VA Med Ctr, Iowa City, IA USA. STVHCS, Audie Murphy Div, San Antonio, TX USA. RP Malone, DC (reprint author), Univ Arizona, Coll Pharm, Dept Pharm Practice & Sci, POB 210207, Tucson, AZ 85721 USA. NR 29 TC 47 Z9 47 U1 1 U2 8 PU PHARMACOTHERAPY PUBLICATIONS INC PI BOSTON PA NEW ENGLAND MEDICAL CENTER BOX 806 171 HARRISON AVE, BOSTON, MA 02111 USA SN 0277-0008 J9 PHARMACOTHERAPY JI Pharmacotherapy PD OCT PY 2000 VL 20 IS 10 BP 1149 EP 1158 DI 10.1592/phco.20.15.1149.34590 PG 10 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 360RM UT WOS:000089681100001 PM 11034037 ER PT J AU Richardson, RD Boswell, T Woods, SC Wingfield, JC AF Richardson, RD Boswell, T Woods, SC Wingfield, JC TI Intracerebroventricular corticotropin-releasing factor decreases food intake in white-crowned sparrows SO PHYSIOLOGY & BEHAVIOR LA English DT Article DE birds; body weight; intraventricular; regulation ID MELOSPIZA-MELODIA; PASSERINE BIRDS; CRF; STRESS; CORTICOSTERONE; PEPTIDE; COMMUNICATION; LOCALIZATION; INVOLVEMENT; METABOLISM AB Neuropeptides such as corticotropin-releasing factor (CRF) may play a role in regulating the pronounced seasonal changes in food intake shown by white-crowned sparrows (Zonotrichia leucophrys gambelii). White-crowned sparrows held on short day length received injections into the third ventricle (icv) of saline or 5.0, 15.0, and 30 mug/kg. Meal size over the subsequent 180 min was significantly depressed in a dose-dependent fashion. Other non-specific behaviors such as preening, hopping, and immobile behaviors appeared to not be affected by a dose that suppressed food intake. This experiment suggests that white-crowned sparrows, when weight-stable, respond to CRF in a manner comparable with several mammalian species. (C) 2000 Elsevier Science Inc. All rights reserved. C1 Vet Affairs Puget Sound Hlth Care Syst, MHC 116, Seattle, WA 98108 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. Roslin Inst, Roslin EH25 9PS, Midlothian, Scotland. Univ Cincinnati, Coll Med, Dept Psychiat, Cincinnati, OH 45267 USA. Univ Washington, Dept Zool, Seattle, WA 98195 USA. RP Richardson, RD (reprint author), Vet Affairs Puget Sound Hlth Care Syst, MHC 116, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [DK-17844] NR 36 TC 15 Z9 15 U1 1 U2 4 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0031-9384 J9 PHYSIOL BEHAV JI Physiol. Behav. PD OCT 1 PY 2000 VL 71 IS 1-2 BP 213 EP 216 DI 10.1016/S0031-9384(00)00326-7 PG 4 WC Psychology, Biological; Behavioral Sciences SC Psychology; Behavioral Sciences GA 385GC UT WOS:000165994400027 PM 11134705 ER PT J AU Carey, K AF Carey, K TI Hospital cost containment and length of stay: An econometric analysis SO SOUTHERN ECONOMIC JOURNAL LA English DT Article ID EXCESS BED CAPACITY; PROSPECTIVE PAYMENT; PANEL-DATA; IMPACTS; DEMAND; CARE AB In recent years, concern in the United States over rising health care costs has led to precipitous reductions in the lengths of hospitalizations. While perceptions of compromised medical care quality following this practice and others have prompted policy makers to consider stricter regulation of health insurance organizations, little attention has been given to the extent to which length of stay reductions are responsible for decreasing hospital costs. This paper provides empirical evidence on that point. The method utilizes a hospital total operating cost function estimated on 2792 U.S. hospitals for the period 1987-1992. Three different panel data estimating techniques are applied, including a random effects model that is distinctive in allowing for correlation between hospital effects and observable regressors, circumventing inconsistency problems following from standard generalized least-squares estimations. The cost elasticity of length of stay is calculated from the regression results. This measure is low, falling in the range 0.09-0.12. It suggests that common perceptions regarding the extent of cost savings resulting from length of stay reductions have been overestimated. C1 US Dept Vet Affairs, Managemetn Sci Grp, Bedford, MA 01730 USA. RP Carey, K (reprint author), US Dept Vet Affairs, Managemetn Sci Grp, 200 Springs Rd, Bedford, MA 01730 USA. NR 33 TC 12 Z9 12 U1 3 U2 8 PU UNIV NORTH CAROLINA PI CHAPEL HILL PA SOUTHERN ECONOMIC JOURNAL, CHAPEL HILL, NC 27514 USA SN 0038-4038 J9 SOUTHERN ECON J JI South. Econ. J. PD OCT PY 2000 VL 67 IS 2 BP 363 EP 380 DI 10.2307/1061475 PG 18 WC Economics SC Business & Economics GA 367CA UT WOS:000090043000007 ER PT J AU Castle, SC AF Castle, SC TI Impact of age-related immune dysfunction on risk of infections SO ZEITSCHRIFT FUR GERONTOLOGIE UND GERIATRIE LA English DT Article DE aging; immunology; immunosenescence; host defenses; SENIEUR protocol ID BLOOD MONONUCLEAR-CELLS; INFLUENZA VACCINATION; VITAMIN-E; ANTIBODY-RESPONSE; HUMAN-LYMPHOCYTES; ELDERLY SUBJECTS; UP-REGULATION; SYSTEM; ZINC; SUPPLEMENTATION AB The elderly have clearly been found to have both increased risk and severity of infections. Immunosenescence, the state of dysregulated immune function with aging, is felt to be a significant contributor to this increased risk. Extensive studies on inbred laboratory animals and in very healthy elderly humans have identified changes in immunity and have identified primarily phenotypic and functional changes in the T cell component of adaptive immunity. However, no compelling scientific evidence has shown that these changes have direct relevance to the common infections seen in the aged population. This perspective will at tempt to shed light on this dilemma. First, it will review clinically relevant infections in the elderly, focusing on influenza and influenza vaccination and how chronic illness contributes to increased risk and severity of infection/failed vaccine response. Next, key changes in immunity will be reviewed, keeping perspective of the impact of confounding variables such as nutrition. If the goal is to prevent serious infections in the elderly, it appears that the field of geriatric immunology/infectious disease is faced with the tremendous challenge of studying a very diverse population of chronically ill individuals in addition to the study of the very healthy elderly. Grouping individuals by dis ease severity or by level of impairment of specific components of immunity may assist in advancing our ability to improve host defense in an at risk population. C1 VA Greater Los Angeles Healthcare Syst, GRECC 11G, Los Angeles, CA 90073 USA. RP Castle, SC (reprint author), VA Greater Los Angeles Healthcare Syst, GRECC 11G, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 53 TC 31 Z9 33 U1 0 U2 3 PU DR DIETRICH STEINKOPFF VERLAG PI DARMSTADT PA PLATZ DER DEUTSCHEN EINHEIT 25, D-64293 DARMSTADT, GERMANY SN 0044-281X J9 Z GERONTOL GERIATR JI Z. Gerontol. Geriatr. PD OCT PY 2000 VL 33 IS 5 BP 341 EP 349 DI 10.1007/s003910070030 PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 375JK UT WOS:000165395600002 PM 11130187 ER PT J AU Turner, BJ Cunningham, WE Duan, N Andersen, RM Shapiro, MF Bozzette, SA Nakazono, T Morton, S Crystal, S St Clair, P Stein, M Zierler, S AF Turner, BJ Cunningham, WE Duan, N Andersen, RM Shapiro, MF Bozzette, SA Nakazono, T Morton, S Crystal, S St Clair, P Stein, M Zierler, S TI Delayed medical care after diagnosis in a US national probability sample of persons infected with human immunodeficiency virus SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT Annual Meeting of the Society-of-General-Internal-Medicine CY MAY 02, 1998 CL WASHINGTON, D.C. SP Soc Gen Internal Med ID LOW-PREVALENCE DISEASES; HEALTH-CARE; SERVICES UTILIZATION; HIV DISEASE; ACCESS; AIDS; INSURANCE; PHYSICIAN; WOMEN; ZIDOVUDINE AB Objective: To identify health care and patient factors associated with delayed initial medical care for human immunodeficiency virus (HIV) infection. Design: Survey of a national probability sample of persons with HIV in care. Settings Medical practices in the contiguous United States. Patients: Cohort A (N=1540) was diagnosed by February 1993 and was in care within 3 years; cohort B (N=1960) was diagnosed by February 1995 and was in care within 1 year of diagnosis. Main Outcome Measure: More than 3- or 6-month delay. Results: Delay of more than 3 months occurred for 29% of cohort A (median, 1 year) and 17% of cohort B. Having a usual source of care at diagnosis reduced delay, with adjusted odds ratios (ORs) of 0.61 (95% confidence interval [CI], 0.48-0.77) in cohort A and 0.70 (95% CI, 0.50-0.99) in cohort B. Medicaid coverage at diagnosis showed lower adjusted ORs of delay compared with private insurance (cohort A: adjusted OR, 0.52; 95% CI, 0.30-0.92; cohort B: adjusted OR, 0.48; 95%, CI, 0.27-0.85). Compared with whites, Latinos had 53%, and 95% higher adjusted ORs of delay (P<.05) in cohorts A and B, respectively, and African Americans had a higher adjusted OR in cohort A (1.56; 95%, CI, 1.19-2.04). The health care factors showed similar effects on delay of greater than 6 months. Conclusions: Medicaid insurance and a usual source of care were protective against delay after HIV diagnosis. After full adjustment, delay was still greater for Latinos and, to a lesser extent, African Americans compared with whites. C1 Univ Penn, Philadelphia, PA 19104 USA. US Dept Vet Affairs, Washington, DC 20420 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Rutgers State Univ, Inst Hlth, New Brunswick, NJ 08903 USA. Crit Path AIDS Project, Philadelphia, PA USA. RAND Corp, Santa Monica, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Rhode Isl Hosp, Providence, RI USA. Brown Univ, Providence, RI 02912 USA. RP Turner, BJ (reprint author), Univ Penn, 1119 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. FU AHRQ HHS [HS08578] NR 34 TC 126 Z9 129 U1 2 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD SEP 25 PY 2000 VL 160 IS 17 BP 2614 EP 2622 DI 10.1001/archinte.160.17.2614 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 357GX UT WOS:000089491100007 PM 10999975 ER PT J AU Slice, LW Bui, L Mak, C Walsh, JH AF Slice, LW Bui, L Mak, C Walsh, JH TI Differential regulation of COX-2 transcription by Ras- and Rho-family of GTPases SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE Rho; GTP-binding proteins; cyclooxygenase-2; gene expression ID SYNTHASE-2 GENE-EXPRESSION; ALPHA-DEPENDENT INDUCTION; GROWTH-FACTOR; BINDING PROTEINS; KAPPA-B; CYCLOOXYGENASE-2; ACTIVATION; CELLS; INHIBITION; CARCINOMA AB Cyclooxygenase-2 (Cox-2) gene expression which is rapidly induced by cytokines, growth factors and tumor promoters, is important for inflammation, angiogenesis, and is markedly enhanced in various cancer cells. Many of these factors initiate signaling through Ras- and Rho-family small GTPases. Here, we investigated the ability of Has, Rac, Rho, and Cdc42Hs to differentially regulate transcription from the murine COX-2 promoter in NIH 3T3 cells. Over-expression of constitutively active mutants of Ras, Rac, Rho, but not Cdc42Hs induced transcription from the COX-2 promoter. Transactivation by Rac and Rho required cis-acting elements located between -80 and -40 of the COX-2 promoter whereas deletion of this region enhanced transactivation by Ras. A CRE/ATF element located at -56 was critical for Ras- and Rac-induced transactivation of the COX-2 promoter, but was not required for transactivation by Rho. This demonstrates Rho-dependent transactivation of the COX-2 promoter through novel trans-acting elements and suggests that, in NM 3T3 cells, signaling by small GTPases that result in COX-2 expression is not through a sequential pathway from Cdc42 to Rac to Rho, but rather through independent, parallel signaling pathways. (C) 2000 Academic Press. C1 Univ Calif Los Angeles, Greater Los Angeles VA Med Ctr, Digest Dis Res Ctr,CURE, Dept Med,Div Digest Dis, Los Angeles, CA 90095 USA. RP Slice, LW (reprint author), Univ Calif Los Angeles, Greater Los Angeles VA Med Ctr, Digest Dis Res Ctr,CURE, Dept Med,Div Digest Dis, 900 Vet Ave, Los Angeles, CA 90095 USA. FU NIDDK NIH HHS [DK17294, DK35740] NR 31 TC 35 Z9 37 U1 0 U2 0 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD SEP 24 PY 2000 VL 276 IS 2 BP 406 EP 410 DI 10.1006/bbrc.2000.3487 PG 5 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 358LB UT WOS:000089558600003 PM 11027488 ER PT J AU Million, M Wang, LX Martinez, V Tache, Y AF Million, M Wang, LX Martinez, V Tache, Y TI Differential Fos expression in the paraventricular nucleus of the hypothalamus, sacral parasympathetic nucleus and colonic motor response to water avoidance stress in Fischer and Lewis rats SO BRAIN RESEARCH LA English DT Article DE Fos-immunoreactivity; corticotropin-releasing hormone (CRF); CRF antagonist; sacral parasympathetic nucleus ID CORTICOTROPIN-RELEASING FACTOR; C-FOS; STRAIN DIFFERENCES; HORMONE; CRF; SYSTEM; NEUROENDOCRINE; BRAIN; SUSCEPTIBILITY; PROJECTIONS AB The responsiveness of hypothalamic CRF to various stressors is reduced in the young female Lewis relative to the histocompatible Fischer rat. Whether such a difference impacts the brain-gut response to water avoidance stress was investigated by monitoring Fos immunoreactivity in the brain and sacral spinal cord and fecal pellet output. Exposure for 60 min to water avoidance stress increased the number of Fos positive cells in the paraventricular nucleus of the hypothalamus (PVN), nucleus tractus solitarius (NTS), and the parasympathetic nucleus of the lumbo-sacral spinal cord (L6-S1) in both Lewis and Fischer rats compared with non stress groups. The Fos response was lower by 32.0% in the PVN, and 63% in sacral parasympathetic nucleus in Lewis compared with Fischer rats while similar Fos expression was observed in the NTS. Stress-induced defecation was reduced by 52% in Lewis compared with Fischer rats while colonic motor response to CRF injected intracisternally resulted in a similar pattern and magnitude of defecation in both strains. The CRF receptor antagonist [D-Phe12,Nle(21,38)C(a)MeLeu(37)]-CRF12-41 injected intracisternally antagonized partly the defecation response in Lewis and Fischer rats. These data indicate that a lower activation of PVN and sacral parasympathetic nuclei in Lewis compared with Fisher rats may contribute to the differential colonic motor response and that the blunted CRF hypothalamic response to stress, unlike responsiveness to central CRF plays a role. (C) 2000 Elsevier Science B.V. All rights reserved. C1 Univ Calif Los Angeles, CURE Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. RP Million, M (reprint author), Univ Calif Los Angeles, CURE Digest Dis Res Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RI Martinez, Vicente/N-1189-2014 FU NIDDK NIH HHS [DK-33061, DK-41301] NR 42 TC 50 Z9 51 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD SEP 22 PY 2000 VL 877 IS 2 BP 345 EP 353 DI 10.1016/S0006-8993(00)02719-0 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 355MB UT WOS:000089388500026 PM 10986349 ER PT J AU Jackson, JG Kreisberg, JI Koterba, AP Yee, D Brattain, M AF Jackson, JG Kreisberg, JI Koterba, AP Yee, D Brattain, M TI Phosphorylation and nuclear exclusion of the forkhead transcription factor FKHR after epidermal growth factor treatment in human breast cancer cells SO ONCOGENE LA English DT Article DE forkhead; FKHR; EGF; breast cancer ID PROTEIN-KINASE-B; CAENORHABDITIS-ELEGANS; DEPENDENT ACTIVATION; SIGNAL-TRANSDUCTION; FACTOR RECEPTORS; BINDING-SITE; INSULIN; AKT; TRANSLOCATION; LONGEVITY AB Akt, when activated by IGF/insulin, can phosphorylate forkhead transcription factors. We undertook this study to determine whether epidermal growth factor (EGF) treatment could produce a signaling cascade resulting in phosphorylation of the forkhead transcription factor FKHR in a breast cancer cell line, MDA-MB-231, After establishing ErbB1, cbl, PI3 kinase and Akt were activated in EGF treated MDA-MB-231, we determined by immunoblot with FKHR antiserum that the electrophoretic mobility of FKHR was retarded after EGF treatment. This mobility retardation was reversible by treatment with alkaline phosphatase, and immunoblot with phospho-Ser(256) FKHR antibody further confirmed phosphorylation on an Akt consensus site after EGF treatment. EGF stimulated FKHR phosphorylation was blocked by the PI3 kinase inhibitor LY294002, and the ErbB1 inhibitor AG1478, FKHR immunoblotting after purification of nuclear and cytoplasmic proteins showed that EGF induced a simultaneous increase of FKHR in the cytoplasm and decrease in the nucleus. This finding was confirmed by immunofluorescence staining. Treatment of cells with pharmacological inhibitors of PI3 kinase or ErbB1 blocked this effect. Thus, these results demonstrate the phosphorylation and nuclear exclusion of FKHR after EGF treatment by a PI3 kinase dependent mechanism, and represent the first report of growth factor regulation of endogenous FKHR localization. C1 Univ Texas, Hlth Sci Ctr, Dept Surg, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Hosp, Div Res & Dev, San Antonio, TX 78229 USA. Univ Minnesota, Ctr Canc, Dept Med, Div Hematol Oncol & Transplantat, Minneapolis, MN 55455 USA. RP Brattain, M (reprint author), Univ Texas, Hlth Sci Ctr, Dept Surg, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NCI NIH HHS [CA74285, CA54807, CA34432] NR 39 TC 63 Z9 63 U1 2 U2 5 PU NATURE PUBLISHING GROUP PI BASINGSTOKE PA HOUNDMILLS, BASINGSTOKE RG21 6XS, HAMPSHIRE, ENGLAND SN 0950-9232 J9 ONCOGENE JI Oncogene PD SEP 21 PY 2000 VL 19 IS 40 BP 4574 EP 4581 DI 10.1038/sj.onc.1203825 PG 8 WC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Oncology; Cell Biology; Genetics & Heredity GA 356HQ UT WOS:000089438200003 PM 11030146 ER PT J AU Fugit, RV Resch, ND AF Fugit, RV Resch, ND TI Conversion of patients from simvastatin to lovastatin in an outpatient pharmacy clinic SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Article; Proceedings Paper CT Western States Conference for Pharmacy Residents, Fellows, and Preceptors CY MAY 05, 1999 CL PACIFIC GROVE, CALIFORNIA ID HYPERCHOLESTEROLEMIA; MANAGEMENT; CARE; PRAVASTATIN; EFFICACY AB The Notes section welcomes the following types of contributions: (1) practical innovations or solutions to everyday practice problems, (2) substantial updates or elaborations on work previously published by the same authors, (3) important confirmations of research findings previously published by others, and (4) shore research reports, including practice surveys, of modest scope or interest. Notes should be submitted with AJHP's manuscript checklist. The text should be concise, and the number of references, tables, and figures should be limited. C1 Denver Vet Affairs Med Ctr, Dept Pharm 119, Denver, CO 80220 USA. Vet Affairs Med Ctr, Albuquerque, NM USA. RP Fugit, RV (reprint author), Denver Vet Affairs Med Ctr, Dept Pharm 119, 1055 Clemont St, Denver, CO 80220 USA. NR 16 TC 14 Z9 14 U1 1 U2 1 PU AMER SOC HEALTH-SYSTEM PHARMACISTS PI BETHESDA PA 7272 WISCONSIN AVE, BETHESDA, MD 20814 USA SN 1079-2082 J9 AM J HEALTH-SYST PH JI Am. J. Health-Syst. Pharm. PD SEP 15 PY 2000 VL 57 IS 18 BP 1703 EP 1708 PG 6 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 358JY UT WOS:000089556000013 PM 11006798 ER PT J AU Rush, AJ Post, RM Nolen, WA Keck, PE Suppes, T Altshuler, L McElroy, SL AF Rush, AJ Post, RM Nolen, WA Keck, PE Suppes, T Altshuler, L McElroy, SL TI Methodological issues in developing new acute treatments for patients with bipolar illness SO BIOLOGICAL PSYCHIATRY LA English DT Article; Proceedings Paper CT Conference on Biopolar Disorder - From Clinical to Clinical, Facing the New Millennium CY JAN 19-21, 2000 CL SCOTTSDALE, ARIZONA SP Soc Biol Psychiat DE acute phase treatment; bipolar illness; methodological issues ID DEPRESSIVE SYMPTOMATOLOGY IDS; PARTIAL-ONSET SEIZURES; ANTIEPILEPTIC DRUGS; LITHIUM TREATMENT; CONTROLLED TRIAL; WORKSHOP REPORT; DOUBLE-BLIND; DISORDER; MANIA; THERAPY AB One important aim of the recent reorganization of the National Institute of Mental Health (NIMH) is to streamline the development of new treatments for patients with severe mental illnesses, such as bipolar disorder, Researching new treatments for patients with bipolar disorder presents specific problems not readily addressed by traditional efficacy trial methodologies that aim to maximize internal validity. This article reexamines several assumptions that have guided the design of these efficacy trials but that also create obstacles for studies of bipolar disorder and suggests potential solutions. This article draws on literature from neurology and psychiatry and discussions at a MacArthur Foundation-sponsored Conference on Longitudinal Methodology in 1992 (David J. Kupfer, MD., Chair), which brought together investigators to consider alternative designs for patients with severe and persistent mental illness, In addition, we benefited from discussions at two NIMH-sponsored conferences, one held in 1989 (Prien and Potter 1990) and the other in 1994 (Prien and Rush 1996), at which investigators and methodologists discussed issues surrounding the development and conduct of informative efficacy trials for patients with bipolar disorder. Based on these discussions and recent literature reviews, we 1) outline common problems in the development and evaluation of effective acute treatments for bipolar disorder and 2) suggest possible solutions to these impediments. We also discuss alternative designs by which to build a sequence of acute treatment studies from which efficacy, safety, and the comparative value of different treatments can be established (C) 2000 Society of Biological Psychiatry. C1 Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX 75390 USA. NIMH, Biol Psychiat Branch, Bethesda, MD 20892 USA. Univ Utrecht, Med Ctr, HC Rumke Grp, Utrecht, Netherlands. Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Cincinnati, Coll Med, Dept Psychiat, Biol Psychiat Program, Cincinnati, OH USA. Stanley Fdn Bipolar Network, Bethesda, MD USA. RP Rush, AJ (reprint author), Univ Texas, SW Med Ctr, Dept Psychiat, 5323 Harry Hines Blvd 9086, Dallas, TX 75390 USA. RI Nolen, Willem/E-9006-2014 OI Rush, Augustus/0000-0003-2004-2382 FU NIMH NIH HHS [MH-53899] NR 68 TC 17 Z9 17 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD SEP 15 PY 2000 VL 48 IS 6 BP 615 EP 624 DI 10.1016/S0006-3223(00)00898-2 PG 10 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 356PY UT WOS:000089452700021 PM 11018232 ER PT J AU Ablashi, DV Chatlynne, L Thomas, D Bourboulia, D Rettig, MB Vescio, RA Viza, D Gill, P Kyle, RA Berenson, JR Whitman, JE AF Ablashi, DV Chatlynne, L Thomas, D Bourboulia, D Rettig, MB Vescio, RA Viza, D Gill, P Kyle, RA Berenson, JR Whitman, JE TI Lack of serologic association of human herpesvirus-8 (KSHV) in patients with monoclonal gammopathy of undetermined significance with and without progression to multiple myeloma SO BLOOD LA English DT Article ID SARCOMA-ASSOCIATED HERPESVIRUS; KAPOSIS-SARCOMA; BONE-MARROW; DENDRITIC CELLS; PERIPHERAL-BLOOD; DNA-SEQUENCES; INFECTION; HUMAN-HERPESVIRUS-8; HHV-8; IDENTIFICATION AB Because human herpesvirus-8 (HHV-8) DNA has been found in multiple myeloma (MM) patients by polymerase chain reaction, it was suggested that HHV-8 may play a role in the transformation of monoclonal gammopathy of undetermined significance (MGUS) to MM. Therefore, 362 MGUS sera with and without progression to MM were tested for IgG antibody to HHV-8. Only 7.8% of the MGUS sera contained HHV-8 antibody to lytic proteins, and IgG antibody to HHV-8 latent antigen was even lower than lytic antibody (2.9%). No differences were observed in the distribution of antibody to HHV-8 in sera from MGUS patients who progressed to MM, The seroprevalences of HHV-8 in MGUS (7.8%), MM (5.4%), and healthy donors (5.9%) were similar, thus arguing for the lack of epidemiologic evidence of HHV-8 participation in the pathogenesis of MM, MGUS patients were immune competent in response to Epstein-Barr virus (EBV) infection be cause 97% contained antibody to EBV virus capsid antigen. (Blood, 2000;96:2304-2306) (C) 2000 by The American Society of Hematology. C1 Adv Biotechnol Inc, Columbia, MD 21046 USA. Georgetown Univ, Sch Med, Washington, DC USA. UCL, Dept Oncol, London WC1E 6BT, England. UCL, Dept Mol Pathol, Windeyer Inst Med Sci, London WC1E 6BT, England. Univ Calif Los Angeles, Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Div Hematol & Oncol, Los Angeles, CA 90073 USA. Saints Peres, Fac Med, Immunol Lab, Paris, France. Univ So Calif, Dept Med, Div Hematol, Los Angeles, CA USA. Mayo Clin, Div Hematol, Rochester, MN USA. RP Ablashi, DV (reprint author), Adv Biotechnol Inc, 9108 Guilford Rd, Columbia, MD 21046 USA. EM dablashi@abionline.com FU NCI NIH HHS [CA62242] NR 26 TC 14 Z9 14 U1 1 U2 1 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD SEP 15 PY 2000 VL 96 IS 6 BP 2304 EP 2306 PG 3 WC Hematology SC Hematology GA 358VN UT WOS:000089578000041 PM 10979981 ER PT J AU Sanders, RD Keshavan, MS Forman, SD Pieri, JN McLaughlin, N Allen, DN van Kammen, DP Goldstein, G AF Sanders, RD Keshavan, MS Forman, SD Pieri, JN McLaughlin, N Allen, DN van Kammen, DP Goldstein, G TI Factor structure of neurologic examination abnormalities in unmedicated schizophrenia SO PSYCHIATRY RESEARCH LA English DT Article; Proceedings Paper CT Annual Meeting of the Society-of-Biological-Psychiatry CY MAY 01-05, 1996 CL NEW YORK, NEW YORK SP Soc Biol Psychiat DE schizophrenia; neurological examination; factor analysis ID SOFT SIGNS AB The heterogeneity and uncertain significance of neurologic exam abnormalities in schizophrenia prompted us to evaluate their factor structure. We administered a modified version of the Neurological Evaluation Scale (NES) to 103 unmedicated patients with schizophrenia. Data were distilled by combining right- and left-side scores, and by eliminating superfluous, rarely abnormal and unreliable items from the analysis. Exploratory principal components analysis yielded four factors: repetitive motor tasks (fist-ring, fist-edge-palm, alternating fist-palm, dysdiadochokinesis); cognitive-perceptual tasks (memory, audiovisual integration, right-left orientation, face-hand test, rhythm tapping reproduction); balancing tasks (Romberg, tandem gait); and the palmomental reflex. Evaluation of the relationship between these factors and clinical and demographic variables revealed a robust correlation between the cognitive-perceptual factor and full-scale IQ score. This analysis is a step toward developing empirical subscales of a modified NES, which may provide insights into the nature of neurologic impairment in schizophrenia and may prove clinically useful. (C) 2000 Published by Elsevier Science Ireland Ltd. C1 VA Pittsburgh Healthcare Syst, Highland Dr Div 7180, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Pittsburgh, PA USA. Univ Nevada, Las Vegas, NV 89154 USA. Robert Wood Johnson Pharmaceut Res Inst, Raritan, NJ USA. RP Goldstein, G (reprint author), VA Pittsburgh Healthcare Syst, Highland Dr Div 7180, 151 R,7180 Highland Dr, Pittsburgh, PA 15206 USA. NR 25 TC 34 Z9 34 U1 0 U2 1 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0165-1781 J9 PSYCHIAT RES JI Psychiatry Res. PD SEP 11 PY 2000 VL 95 IS 3 BP 237 EP 243 DI 10.1016/S0165-1781(00)00176-1 PG 7 WC Psychiatry SC Psychiatry GA 356VL UT WOS:000089463500006 PM 10974362 ER PT J AU Anzueto, A Angel, L AF Anzueto, A Angel, L TI Update in pulmonary disease SO ANNALS OF INTERNAL MEDICINE LA English DT Review C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Affairs Hlth Care Syst, San Antonio, TX USA. RP Anzueto, A (reprint author), Vet Affairs Med Ctr, 111E,7400 Merton Minter Blvd, San Antonio, TX 78284 USA. NR 2 TC 3 Z9 3 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD SEP 5 PY 2000 VL 133 IS 5 BP 360 EP 366 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 350QD UT WOS:000089111900006 PM 10979881 ER PT J AU Small, GW AF Small, GW TI Investigations into geriatric psychiatry challenges - AAGP Senior Investigator Award 2000 SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article ID ONSET ALZHEIMER-DISEASE; CEREBRAL GLUCOSE-METABOLISM; MEMORY SELF-APPRAISAL; E TYPE-4 ALLELE; APOLIPOPROTEIN-E; HLA-A2 ALLELE; MASS HYSTERIA; OLDER ADULTS; ASSOCIATION; AGE AB The author summarizes the American Association for Geriatric Psychiatry Senior Investigator Award presentation delivered at the 13th Annual Meeting March 12-15, 2000, in Miami Bench, Florida, and reviews his research studies that define a trajectory leading to investigations of early detection and prevention of Alzheimer's disease (AD). Themes and critical transitions that fostered the research are emphasized and effective collaboration mentoring, and timing are discussed These studies have combined neuroimaging and genetic methods to identify subjects before they develop AD, so that interventions might delay dementia onset. The eventual goal is to translate the clinical research discoveries into modern clinical practice. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Alzheimers Dis Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Ctr Aging, Los Angeles, CA 90024 USA. VA Greater Los Angles Healthcare Syst, Los Angeles, CA USA. RP Small, GW (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, Room 88-201,760 Westwood Plaza, Los Angeles, CA 90024 USA. FU NIA NIH HHS [AG10123, AG13308]; NIMH NIH HHS [MH52453] NR 33 TC 1 Z9 1 U1 6 U2 6 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD FAL PY 2000 VL 8 IS 4 BP 276 EP 283 PG 10 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 364RG UT WOS:000089906200002 PM 11069266 ER PT J AU Oxman, TE Barrett, JE Sengupta, A Williams, JW AF Oxman, TE Barrett, JE Sengupta, A Williams, JW TI The relationship of aging and dysthymia in primary case SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article; Proceedings Paper CT 11th Annual Meeting of the American-Association-Geriatric-Psychiatry CY MAR 08-11, 1998 CL SAN DIEGO, CALIFORNIA SP Amer Assoc Geriatr Psychiat ID PRIMARY CARE PRACTICE; MENTAL-DISORDERS; DEPRESSION; HEALTH; OUTCOMES; ILLNESS AB The authors compared symptomatic and functional characteristics between older (age greater than or equal to 60; n =9 1) and younger (age 18-59 n = 125)primary care patients with dysthymia. Three of six significantly different depression symptoms were of moderate-to-large effect size with the older group having a lower proportion reporting the symptom. The older group had a worse physical health function score brit a better mental health function score. There appears to be a core of symptoms and functional impatient that generalizes across the age span. There are also significant age differences. Growing older appears to have an impact on the nature of what it means to have dysthymia. C1 Dartmouth Med Sch, Dept Psychiat, Lebanon, NH 03756 USA. Western Psychiat Inst, Pittsburgh, PA USA. Univ Texas, S Texas Vet Hlth Care Syst, Audie Murphy Div, Gen Internal Med Sect, San Antonio, TX 78285 USA. Univ Washington, Dept Psychiat, Seattle, WA 98195 USA. RP Oxman, TE (reprint author), Dartmouth Med Sch, DHMC, 1 Med Ctr Dr, Lebanon, NH 03756 USA. RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558 NR 32 TC 5 Z9 5 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD FAL PY 2000 VL 8 IS 4 BP 318 EP 326 DI 10.1176/appi.ajgp.8.4.318 PG 9 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 364RG UT WOS:000089906200008 PM 11069272 ER PT J AU Gordon, HS Aron, DC Fuehrer, SM Rosenthal, GE AF Gordon, HS Aron, DC Fuehrer, SM Rosenthal, GE TI Using severity-adjusted mortality to compare performance in a veterans affairs hospital and in private-sector hospitals SO AMERICAN JOURNAL OF MEDICAL QUALITY LA English DT Article; Proceedings Paper CT 14th Annual Meeting of the Department-of-Veterans-Affairs-Health-Services-Research-and-Development- Service CY FEB 29, 1996 CL WASHINGTON, D.C. SP Dept Vet Affairs Htlh Serv Res & Dev Serv DE hospital mortality; outcome assessment; regression analysis; veterans hospitals ID HEALTH-CARE SYSTEM; POSTOPERATIVE MORTALITY; QUALITY; VA; DEATH; MEDISGROUPS; ADMISSION; SURGERY; STAY; RISK AB The objective of this study was to compare hospital mortality in Veterans Affairs (VA) and private-sector patients. The study included 5016 patients admitted to 1 VA hospital. Admission severity of illness was measured using a commercial methodology that was developed in a nationwide database of 850,000 patients from 111 private-sector hospitals. The method uses data abstracted from patients' medical records to predict the risk of death in individual patients, based on the normative database. Analyses compared actual and predicted mortality rates in VA patients. VA patients had higher (P < .05) severity of illness than private-sector patients. The observed mortality rate in VA patients was 4.0% and was similar (P = .09) to the predicted risk of death (4.4%; 95% confidence interval 4.0-4.9%). In subgroup analyses, actual and predicted mortality rates were similar in medical and surgical patients and in groups stratified according to severity of illness, except in the highest severity stratum, in which actual mortality was lower than predicted mortality (57% vs 73%; P < .001), We found that in-hospital mortality in 1 VA hospital and a nationwide sample of private-sector hospitals were similar, after adjusting for severity of illness. Although not directly generalizable to other VA hospitals, our findings nonetheless suggest that the quality of VA and private-sector care may be similar with respect to one important and widely used measure. C1 Houston VAMC, Dept Internal Med, Sect Gen Med, Houston, TX 77030 USA. Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Case Western Reserve Univ, Sch Med, Div Clin & Mol Endocrinol, Cleveland, OH USA. Case Western Reserve Univ, Sch Med, Inst Hlth Care Res, Cleveland, OH USA. Cleveland Vet Affairs Med Ctr, Cleveland, OH USA. Univ Iowa, Div Gen Internal Med, Iowa City, IA USA. Iowa City VA Med Ctr, Iowa City, IA USA. RP Gordon, HS (reprint author), Houston VAMC, Dept Internal Med, Sect Gen Med, 2002 Holcombe Blvd, Houston, TX 77030 USA. RI Gordon, Howard/E-4420-2010 OI Gordon, Howard/0000-0002-6712-5954 NR 28 TC 18 Z9 18 U1 1 U2 2 PU AMER COLLEGE MEDICAL QUALITY PI BETHESDA PA 4334 MONTGOMERY AVE, 2ND FL, BETHESDA, MD 20814-4402 USA SN 1062-8606 J9 AM J MED QUAL JI Am. J. Med. Qual. PD SEP-OCT PY 2000 VL 15 IS 5 BP 207 EP 211 DI 10.1177/106286060001500505 PG 5 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 360MF UT WOS:000089671100005 PM 11022367 ER PT J AU Chesnut, CH Silverman, S Andriano, K Genant, H Gimona, A Harris, S Kiel, D LeBoff, M Maricic, M Miller, P Moniz, C Peacock, M Richardson, P Watts, N Baylink, D AF Chesnut, CH Silverman, S Andriano, K Genant, H Gimona, A Harris, S Kiel, D LeBoff, M Maricic, M Miller, P Moniz, C Peacock, M Richardson, P Watts, N Baylink, D CA PROOF Study Grp TI A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the prevent recurrence of osteoporotic fractures study SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID 2-SITE IMMUNORADIOMETRIC ASSAY; INCIDENT VERTEBRAL FRACTURES; LONG-TERM TREATMENT; BONE MASS; NEUTRALIZING ANTIBODIES; INTRANASAL CALCITONIN; PARATHYROID-HORMONE; BIOCHEMICAL MARKERS; PAGETS-DISEASE; DOSE-RESPONSE AB PURPOSE: We conducted a 5-year, double-blind, randomized, placebo-controlled study to determine whether salmon calcitonin nasal spray reduced the risk of new vertebral fractures in postmenopausal women with osteoporosis. SUBJECTS AND METHODS: A total of 1,255 postmenopausal women with established osteoporosis were randomly assigned to receive salmon calcitonin nasal spray (100, 200, or 400 IU) or placebo daily. All participants received elemental calcium (1,000 mg) and vitamin D (400 IU) daily. Vertebral fractures were assessed with lateral radiographs of the spine. The primary efficacy endpoint was the risk of new vertebral fractures in the salmon calcitonin nasal spray 200-IU group compared with the placebo group. RESULTS: During 5 years, 1,108 participants had at least one follow-up radiograph. A total of 783 women completed 3 years of treatment, and 511 completed 5 years. The 200-IU dose of salmon calcitonin nasal spray significantly reduced the risk of new vertebral fractures by 33% compared with placebo [200 IU: 51 of 287, placebo: 70 of 270, relative risk (RR) = 0.67, 95% confidence interval (CI): 0.47- to 0.97, P = 0.03]. In the 817 women with one to five prevalent vertebral fractures at enrollment, the risk was reduced by 36% (RR = 0.64, 95% CI: 0.43- to 0.96, P = 0.03). The reductions in vertebral fractures in the 100-IU (RR = 0.85, 95% CI: 0.60- to 1.21) and the 400-IU (RR = 0.84, 95% CI: 0.59- to 1.18) groups were not significantly different from placebo. Lumbar spine bone mineral density increased significantly from baseline (1% to 1.5%, P <0.01) in all active treatment groups. Bone turnover was inhibited, as shown by suppression of serum type-I collagen cross-linked telopeptide (C-telopeptide) by 12% in the 200-IU group (P <0.01) and by 14% in the 400-IU group (P <0.01) as compared with placebo. CONCLUSION: Salmon calcitonin nasal spray at a dose of 200 IU daily significantly reduces the risk of new vertebral fractures in postmenopausal women with osteoporosis. Am J Med. 2000;109:267-276. (C) 2000 by Excerpta Medica, Inc. C1 Univ Washington, Med Ctr, Seattle, WA 98105 USA. Univ Calif Los Angeles, Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Beverly Hills, CA USA. Novartis Pharmaceut, E Hanover, NJ USA. Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. Novartis Pharma AG, Basel, Switzerland. Rhode Isl Hosp, Providence, RI USA. Brigham & Womens Hosp, Boston, MA 02115 USA. Univ Arizona, Arizona Hlth Sci Ctr, Tucson, AZ USA. Colorado Ctr Bone Res, Lakewood, CO USA. Kings Coll Hosp London, London, England. Indiana Univ, Med Ctr, Indianapolis, IN USA. Emory Clin, Atlanta, GA 30322 USA. Loma Linda Univ, Jerry L Pettis Mem Vet Hosp, Loma Linda, CA 92357 USA. RP Chesnut, CH (reprint author), Univ Washington, Med Ctr, 1107 NE 45th St,Suite 440, Seattle, WA 98105 USA. OI Kiel, Douglas/0000-0001-8474-0310 NR 53 TC 592 Z9 633 U1 4 U2 25 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 EI 1555-7162 J9 AM J MED JI Am. J. Med. PD SEP PY 2000 VL 109 IS 4 BP 267 EP 276 DI 10.1016/S0002-9343(00)00490-3 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 354XM UT WOS:000089356600001 PM 10996576 ER PT J AU Yang, H Kawakubo, K Wong, H Ohning, G Walsh, J Tache, Y AF Yang, H Kawakubo, K Wong, H Ohning, G Walsh, J Tache, Y TI Peripheral PYY inhibits intracisternal TRH-induced gastric acid secretion by acting in the brain SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE immunoneutralization; vagus; dorsal vagal complex ID THYROTROPIN-RELEASING-HORMONE; DORSAL MOTOR NUCLEUS; INTRACEREBROVENTRICULAR PASSIVE-IMMUNIZATION; FOS-LIKE IMMUNOREACTIVITY; MEDULLARY RAPHE NUCLEI; PEPTIDE-YY; RAT-BRAIN; VAGAL COMPLEX; BINDING-SITES; RECEPTOR AB The site of action of peripheral peptide YY (PYY)-induced inhibition of vagally stimulated gastric acid secretion was studied using immunoneutralization with PYY antibody in urethan-anesthetized rats. Gastric acid secretion (59 +/- 7 mmol/90 min) stimulated by intracisternal injection of the stable thyrotropin-releasing hormone (TRH) analog RX-77368 (14 pmol/rat) was dose-dependently inhibited by 52%, 69%, and 83% by intravenous infusion of 0.25, 0.5, and 1.0 nmol.kg(-1).h(-1) PYY, respectively. PYY or PYY3-36 (2.4 pmol/rat) injected intracisternally also inhibited the acid response to intracisternal RX-77368 by 73% and 80%, respectively. Intravenous pretreatment with PYY antibody (4.5 mg/rat), which shows a 35% cross-reaction with PYY3-36 by RIA, completely prevented the inhibitory effect of intravenously infused PYY (1 nmol.kg(-1).h(-1)). When injected intracisternally, the PYY antibody (280 mu g/rat) reversed intracisternal PYY (2.4 pmol)- and intravenous PYY (1 nmol.kg(-1).h(-1))-induced inhibition of acid response to intracisternal RX-77368 by 64% and 93.5%, respectively. These results provide supporting evidence that peripheral PYY inhibits central vagal stimulation of gastric acid secretion through an action in the brain. C1 Univ Calif Los Angeles, Sch Med, Vet Affairs Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Div Digest Dis, Los Angeles, CA 90073 USA. RP Yang, H (reprint author), Univ Calif Los Angeles, Sch Med, Vet Affairs Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Bldg 115,Rm 203,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-41301, DK-30110, DK-50255] NR 43 TC 16 Z9 16 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD SEP PY 2000 VL 279 IS 3 BP G575 EP G581 PG 7 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 347UB UT WOS:000088946600014 PM 10960357 ER PT J AU Cornford, EM Nguyen, EV Landaw, EM AF Cornford, EM Nguyen, EV Landaw, EM TI Acute upregulation of blood-brain barrier glucose transporter activity in seizures SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE blood-brain barrier glucose transporter; maximal velocity; half-saturation constant; pentylene tetrazole seizures; unsaturated permeability-surface area products; transporter recruitment; intrinsic activity ID ELECTRON-MICROSCOPIC IMMUNOGOLD; RAT-BRAIN; DOWN-REGULATION; FLOW; METABOLISM; REGIONS; KINETICS; GERBIL; INFLUX; PLASMA AB Brain extraction of F-18-labeled 2-fluoro-2-deoxy-D-glucose (FDG) was significantly higher in pentylene tetrazole (PTZ)-treated rats (32 +/- 4%) than controls (25 +/- 4%). The FDG permeability-surface area product (PS) was also significantly higher with PTZ treatment (0.36 +/- 0.05 ml.min(-1).g(-1)) than in controls (0.20 +/- 0.06 ml.min(-1).g(-1)). Cerebral blood flow rates were also elevated by 50% in seizures. The internal carotid artery perfusion technique indicated mean [C-14]glucose clearance (and extraction) was increased with PTZ treatment, and seizures increased the PS by 37 +/- 16% (P < 0.05) in cortical regions. Because kinetic analyses suggested the glucose transporter half-saturation constant (K-m) was unchanged by PTZ, we derived estimates of 1) treated and 2) control maximal transporter velocities (V-max) and 3) a single K-m. In cortex, the glucose transporter V-max was 42 +/- 11% higher (P < 0.05) in PTZ-treated animals (2.46 +/- 0.34 mu mol.min(-1).g(-1)) than in control animals (1.74 +/- 0.26 mu mol.min(-1).g(-1)), and the K-m = 9.5 +/- 1.6 mM. Blood-brain barrier (BBB) V-max was 31 +/- 10% greater (P < 0.05) in PTZ-treated (2.36 +/- 0.30 mu mol.min(-1).g(-1)) than control subcortex (1.80 +/- 0.25 mu mol.min(-1).g(-1)). We conclude acute upregulation of BBB glucose transport occurs within 3 min of an initial seizure. Transporter V-max and BBB glucose permeability increase by 30-40%. C1 Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Biomath, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Vet Adm W Los Angeles Med Ctr, Neurol Serv W127, SW Reg Vet Adm Epilepsy Ctr, Los Angeles, CA 90073 USA. RP Cornford, EM (reprint author), VA Greater Los Angeles Healthcare Syst, Vet Adm W Los Angeles Med Ctr, Neurol Serv W127, SW Reg Vet Adm Epilepsy Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NINDS NIH HHS [NS-25554, NS-37360] NR 28 TC 34 Z9 34 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD SEP PY 2000 VL 279 IS 3 BP H1346 EP H1354 PG 9 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 355HC UT WOS:000089379400058 PM 10993802 ER PT J AU Chen, R Mukhin, YV Garnovskaya, MN Thielen, TE Iijima, Y Huang, C Raymond Jr Ullian, ME Paul, RV AF Chen, R Mukhin, YV Garnovskaya, MN Thielen, TE Iijima, Y Huang, C Raymond, JR Ullian, ME Paul, RV TI A functional angiotensin II receptor-GFP fusion protein: evidence for agonist-dependent nuclear translocation SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE green fluorescent protein; losartan; confocal microscopy; internalization ID GREEN FLUORESCENT PROTEIN; VASCULAR SMOOTH-MUSCLE; LIGAND-INDUCED TRAFFICKING; BETA(2)-ADRENERGIC RECEPTOR; SIGNAL-TRANSDUCTION; BINDING SITES; INTERNALIZATION; CELLS; VISUALIZATION; ENDOCYTOSIS AB We constructed an expression vector for a fusion protein [ANG II type 1a receptor-green fluorescent protein (AT(1a)R-GFP)] consisting of enhanced GFP attached to the COOH terminus of the rat AT(1a)R. Chinese hamster ovary (CHO) cells transfected with AT(1a)R-GFP demonstrated specific, high-affinity (125)I-labeled ANG II binding (IC(50) 21 nM). ANG II exposure stimulated sodium-proton exchange and cytoplasmic calcium release to a similar extent in cells transfected with AT(1a)R or AT(1a)R-GFP; these responses were desensitized by prior exposure to ANG II and were sensitive to the AT(1)R blocker losartan. ANG II-driven internalization of AT(1a)R-GFP in transfected CHO cells was demonstrated both by radioligand binding and by laser scanning confocal microscopy. Colocalization of GFP fluorescence with that of the nuclear stain TOTO-3 in confocal images was increased more than twofold after 1 h of ANG II exposure. We conclude that AT(1a)R-GFP exhibits similar pharmacological behavior to that of the native AT(1a)R. Our observations also support previous evidence for the presence of AT(1a)R in the nucleus and suggest that the density of AT(1a)R in the nucleus may be regulated by exposure to its ligand. C1 Med Univ S Carolina, Div Nephrol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Med Specialty Serv, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Res Serv, Charleston, SC 29425 USA. RP Paul, RV (reprint author), Med Univ S Carolina, Div Nephrol, 829 CSB, Charleston, SC 29425 USA. EM paulr@musc.edu FU NCRR NIH HHS [S10-RR-13005]; NIDDK NIH HHS [R01-DK-52448] NR 31 TC 71 Z9 71 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD SEP PY 2000 VL 279 IS 3 BP F440 EP F448 PG 9 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 349FX UT WOS:000089033900005 PM 10966923 ER PT J AU Hirakura, Y Yiu, WW Yamamoto, A Kagan, BL AF Hirakura, Y Yiu, WW Yamamoto, A Kagan, BL TI Amyloid peptide channels: blockade by zinc and inhibition by Congo red (amyloid channel block) SO AMYLOID-INTERNATIONAL JOURNAL OF EXPERIMENTAL AND CLINICAL INVESTIGATION LA English DT Article DE amyloid; membranes; pores; electrophysiology; amylin; prion ID PRION PROTEIN-FRAGMENT; DIABETES-MELLITUS; TRANSGENIC MICE; NEUROTOXICITY; DISEASE; BIOLOGY AB Amyloid peptides are the major constituents of amyloid deposits in various amyloid diseases including Alzheimer's disease, type II diabetes mellitus, prion diseases and others. The hallmark of amyloid is the binding of the dye, Congo red, which creates characteristic staining doe to the dye's ability to bind the beta sheet aggregates referred to as amyloid. Previous reports have demonstrated that several cytotoxic, amyloidogenic peptides can form ion channels in planar phospholipid bilayer membranes and have suggested that these channels may represent the pathogenic mechanism of cell and tissue destruction in amyloid disease. Furthermore, zinc and Congo red can ameliorate or prevent the pathogenic effect of certain amyloid peptides. We report here that zinc at micromolar concentrations caused a reversible blockade of islet amyloid polypeptide (IAPP, amylin) and PrP 106-126 channels whereas calcium and magnesium did not. Congo red completely inhibited channel formation if preincubated with amyloid peptides, but had no effect on IAPP or PrP 106-126 channels once formed These results suggest a requirement for aggregation for the formation of amyloid peptide channels and are consistent with the "channel hypothesis" of amyloid disease. They also suggest potential avenues for ameliorative therapy of these illnesses. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Dept Psychiat,Neuropsychiat Inst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Mental Retardat Res Ctr, Los Angeles, CA 90024 USA. RP Kagan, BL (reprint author), 760 Westwood Plaza, Los Angeles, CA 90024 USA. FU NIMH NIH HHS [MHO1174] NR 25 TC 59 Z9 59 U1 0 U2 7 PU PARTHENON PUBLISHING GROUP PI CARNFORTH LANCASHIRE PA CASTERTON HALL, CARNFORTH LANCASHIRE LA6 2LA, ENGLAND SN 1350-6129 J9 AMYLOID JI Amyloid-Int. J. Exp. Clin. Investig. PD SEP PY 2000 VL 7 IS 3 BP 194 EP 199 DI 10.3109/13506120009146834 PG 6 WC Biochemistry & Molecular Biology; Medicine, General & Internal; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; General & Internal Medicine; Research & Experimental Medicine GA 359FH UT WOS:000089600500005 PM 11019860 ER PT J AU Gibson, GE Haroutunian, V Zhang, H Park, LCH Shi, Q Lesser, M Mohs, RC Sheu, RKF Blass, JP AF Gibson, GE Haroutunian, V Zhang, H Park, LCH Shi, Q Lesser, M Mohs, RC Sheu, RKF Blass, JP TI Mitochondrial damage in Alzheimer's disease varies with apolipoprotein E genotype SO ANNALS OF NEUROLOGY LA English DT Article ID ALPHA-KETOGLUTARATE DEHYDROGENASE; CEREBRAL GLUCOSE-METABOLISM; E EPSILON-4 ALLELE; COMPLEX ACTIVITY; PYRUVATE-DEHYDROGENASE; RELATIVE IMPORTANCE; ENZYME-ACTIVITIES; OXIDATIVE STRESS; POSTMORTEM BRAIN; DLST GENOTYPE AB Brain metabolism and the activity of the alpha -ketoglutarate dehydrogenase complex (KGDHC), a mitochondrial enzyme, are diminished in brains from patients with Alzheimer's disease (AD). In 109 subjects, the Clinical Dementia Rating (CDR) score was highly correlated with brain KGDHC activity. In AD patients who carried the epsilon 4 allele of the apolipoprotein E gene (ApoE4), the CDR score correlated better with KGDHC activity than with the densities of neuritic plaques or neuritic tangles. In contrast, in patients without ApoE4, the CDR score correlated significantly better with tangles and plaques than with KGDHC activity. The results suggest that mitochondrial/oxidative damage may be more important for the cognitive dysfunction in AD patients who early ApoE4 than in those who do not. C1 Cornell Univ, Weill Med Coll, Burke Med Res Inst, Dept Neurol, White Plains, NY 10605 USA. Cornell Univ, Weill Med Coll, Dept Neurosci, White Plains, NY 10605 USA. CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Bronx, NY USA. Northshore Hosp, Manhasset, NY USA. RP Gibson, GE (reprint author), Cornell Univ, Weill Med Coll, Burke Med Res Inst, Dept Neurol, 785 Mamaroneck Ave, White Plains, NY 10605 USA. FU NIA NIH HHS [AG14930, AG11921, AG14600] NR 50 TC 118 Z9 120 U1 2 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0364-5134 J9 ANN NEUROL JI Ann. Neurol. PD SEP PY 2000 VL 48 IS 3 BP 297 EP 303 DI 10.1002/1531-8249(200009)48:3<297::AID-ANA3>3.0.CO;2-Z PG 7 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 349BU UT WOS:000089024600003 PM 10976635 ER PT J AU MaWhinney, S Brown, ER Malcolm, J VillaNueva, C Groves, BM Quaife, RA Lindenfeld, J Warner, BA Hammermeister, KE Grover, FL Shroyer, ALW AF MaWhinney, S Brown, ER Malcolm, J VillaNueva, C Groves, BM Quaife, RA Lindenfeld, J Warner, BA Hammermeister, KE Grover, FL Shroyer, ALW TI Identification of risk factors for increased cost, charges, and length of stay for cardiac patients SO ANNALS OF THORACIC SURGERY LA English DT Article ID SEVERITY; QUALITY; SURGERY; ILLNESS; HEALTH; MODEL AB Background. In this study we explored different risk model options to provide clinicians with predictions for resource utilization. The hypotheses were that predictors of mortality are not predictive of resource consumption, and that there is a correlation between cost estimates derived using a cost-to-charge ratio or a product-line costing approach. Methods. From March 1992 to June 1995, 2,481 University of Colorado Hospital patients admitted for ischemic heart disease were classified by diagnosis-related group code as having undergone or experienced coronary bypass procedures (CBP), percutaneous cardiovascular procedures (PCVP), acute myocardial infarction (AMI), and other cardiac-related discharges (Other). For each diagnosis-related group, Cox proportional hazards models were developed to determine predictors of cost, charges, and length of stay. Results. The diagnosis groups differed in the clinical factors that predicted resource use. As the two costing methods were highly correlated either approach may be used to assess relative resource consumption provided costs are reconciled to audited financial statements. Conclusions. To develop valid prediction models for costs of care, the clinical risk factors that are traditionally used to predict risk-adjusted mortality may need to be expanded. (Ann Thorac Surg 2000;70:702-10) (C) 2000 by The Society of Thoracic Surgeons. C1 Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Surg, Denver, CO 80262 USA. USAF Acad, Dept Math, Colorado Springs, CO 80840 USA. Dept Vet Affairs Med Ctr, Denver, CO USA. RP Shroyer, ALW (reprint author), Denver VA Med Ctr, Div Cardiac Res, 1035 Clermont St 151R, Denver, CO 80220 USA. RI Brown, Elizabeth/A-8984-2008; Shroyer, Annie Laurie/B-8836-2016 OI Shroyer, Annie Laurie/0000-0001-6461-0623 NR 20 TC 17 Z9 18 U1 1 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0003-4975 J9 ANN THORAC SURG JI Ann. Thorac. Surg. PD SEP PY 2000 VL 70 IS 3 BP 702 EP 710 DI 10.1016/S0003-4975(00)01510-1 PG 9 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 356MQ UT WOS:000089447400003 PM 11016297 ER PT J AU Johnson, DA Yeh, CK Dodds, MWJ AF Johnson, DA Yeh, CK Dodds, MWJ TI Effect of donor age on the concentrations of histatins in human parotid and submandibular/sublingual saliva SO ARCHIVES OF ORAL BIOLOGY LA English DT Article DE histatins; parotid saliva; submandibular/sublingual saliva; ageing ID HISTIDINE-RICH POLYPEPTIDES; CANDIDA-ALBICANS; FLOW-RATE; ANTIMICROBIAL PROTEINS; ANTIFUNGAL ACTIVITY; FUNGICIDAL ACTIVITY; HIV-1 INFECTION; HEALTHY-ADULTS; SECRETORY IGA; WHOLE SALIVA AB Histatins are small proteins of human glandular saliva that have antifungal properties. Recent studies show that oral candidal infections increase with age, suggesting an age-associated compromise in oral host defence. Here, the effect of age and of physiological gland stimulation on the concentration and secretion of salivary histatins was investigated. Parotid and submandibular/sublingual salivas were collected from six young adults under unstimulated, mechanical (chewing) and gustatory (0.025 M and 0.1 M citric acid) stimulation, and the concentration and secretion of histatins was measured by cationic polyacrylamide gel electrophoresis with subsequent densitometric scanning of the stained gels. With gland stimulation, parotid saliva showed no significant increase in histatin concentration (mu g/ml); however, histatin secretion (mu g/min) increased up to 26-fold (p < 0.005; ANOVA). Stimulation of submandibular/sublingual saliva resulted in significant increases in both histatin concentration (p < 0.005) and secretion (p < 0.0005). Ageing effects on salivary histatins were determined in citric acid (0.1 M)-stimulated parotid and submandibular/sublingual saliva samples collected from 80 individuals (divided into four age groups having approximately equal numbers of males and females: 35-44 years; 45-54 years; 55-64 years and 65-76 years). None of the patients was taking medications or wore dentures. ANOVA showed no sex differences in histatins. Regression analysis showed significant age-associated decreases for parotid saliva histatin concentration (p < 0.002) and secretion (p < 0.002) as well as for submandibular/sublingual saliva histatin concentration (p < 0.0001) and secretion (p < 0.0001). Both saliva types showed significant (p < 0.0001) decreases in the histatin concentration per mg of total protein, suggesting a preferential decrease in salivary histatins compared to total salivary protein. These results suggest that the salivary histatin component of the oral host defence system is compromised with increasing age. (C) 2000 Elsevier Science Ltd. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Sch Dent, Dept Community Dent 7917, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Sch Dent, Dept Dent Diagnost Sci 7919, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Geriatr Res Educ & Clin Ctr 182, San Antonio, TX 78284 USA. RP Johnson, DA (reprint author), Univ Texas, Hlth Sci Ctr, Sch Dent, Dept Community Dent 7917, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NIDCR NIH HHS [DE10756] NR 47 TC 38 Z9 41 U1 0 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0003-9969 J9 ARCH ORAL BIOL JI Arch. Oral Biol. PD SEP PY 2000 VL 45 IS 9 BP 731 EP 740 DI 10.1016/S0003-9969(00)00047-9 PG 10 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 346AP UT WOS:000088848200003 PM 10869486 ER PT J AU Burnfield, JM Josephson, KR Powers, CM Rubenstein, LZ AF Burnfield, JM Josephson, KR Powers, CM Rubenstein, LZ TI The influence of lower extremity joint torque on gait characteristics in elderly men SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article; Proceedings Paper CT 51st Annual Scientific Meeting of the Gerontological-Society-of-America CY NOV 20-24, 1998 CL PHILADELPHIA, PENNSYLVANIA SP Gerontol Soc Amer DE gait; muscles; strength; geriatrics, elderly; rehabilitation ID RECURRENT FALLS; STRENGTH; EXERCISE; PREDICTORS; VELOCITY; PEOPLE; MUSCLE; WOMEN; HOME; AGE AB Objective: To examine the relation between certain lower extremity isokinetic muscle torque capabilities and selected stride characteristics for a group of elderly, sedentary men. Study Design: Descriptive analysis of convenience sample. Setting: Veterans Administration (VA) ambulatory care center. Subjects: Eighty-one elderly men, capable of independent ambulation, were recruited from outpatient clinics and the local community (mean age, 74.7yr). Main Outcome Measures: Maximal isokinetic torque in the sagittal plane of hip, knee, and ankle muscles; stride characteristics of speed, stride length, and cadence recorded during walking at a self-selected velocity. Results: Stepwise regression analysis revealed that hip extension torque was the only significant independent predictor for free walking speed, stride length, and cadence, and accounted for 37% (r = .611), 35% (r = .590), and 12% (r = .341) of the total variance, respectively. Other joint torques correlated with gait parameters but did not add significantly to the multivariate model. Conclusions: Hip extension torque was the only significant independent predictor for free walking velocity, stride length, and cadence in this group. These results support the idea that strengthening the hip extensors may improve stride characteristics in elderly individuals. C1 VA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr & Nursing Home, Geriatr Res Educ & Clin Ctr 11E, Sepulveda, CA 91343 USA. Univ So Calif, Dept Biokinesiol & Phys Therapy, Los Angeles, CA USA. RP Rubenstein, LZ (reprint author), VA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr & Nursing Home, Geriatr Res Educ & Clin Ctr 11E, 16111 Plummer St, Sepulveda, CA 91343 USA. RI Powers, Christopher/J-2662-2014 NR 24 TC 33 Z9 33 U1 2 U2 5 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD SEP PY 2000 VL 81 IS 9 BP 1153 EP 1157 DI 10.1053/apmr.2000.7174 PG 5 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 350PM UT WOS:000089110400004 PM 10987153 ER PT J AU Navder, KP Baraona, E Lieber, CS AF Navder, KP Baraona, E Lieber, CS TI Dilinoleoylphosphatidylcholine protects human low density lipoproteins against oxidation SO ATHEROSCLEROSIS LA English DT Article DE phospholipids; anti-oxidants; low-density lipoproteins; atherosclerosis ID VITAMIN-E CONSUMPTION; LIPID-PEROXIDATION; FATTY-ACIDS; POLYENYLPHOSPHATIDYLCHOLINE; ATHEROSCLEROSIS; RISK; SUSCEPTIBILITY; FIBROSIS; BABOONS; ALCOHOL AB LDL oxidation may promote atherosclerosis. We found that polyenyphosphatidylcholine (PPC), a mixture of polyunsaturated phospholipids extracted from soybeans, has antioxidant effects in in vivo models of oxidative stress. To assess whether components of PPC affect the in vitro oxidizability of LDL, plasma from 15 healthy volunteers was incubated with 10 mu M of either dilinoleoyl-, palmitoyl-linoleoyl-, linoleoyl-palmitoyl- or distearoyl-phosphatidylcholine as well as 10 mu M and 1 mM alpha-tocopherol. LDL oxidation was initiated with 5 mu M Cu2+ sulfate and monitored by conjugated diene production, or with 2,2'-azobis (2-amidinopropane) dihydrochloride. a free radical generator, and monitored by O-2 consumption. After addition of Cu2+, the lag phase (indicative of resistance of LDL to oxidation) was longer (140% of controls; P < 0.001) for LDL incubated with dilinoleoyl-. but not with the other phosphatidylcholine species. This effect was similar to that of 1 mM alpha-tocopherol (135%,). After addition of 2,2'-azobis (2-amidinopropane) dihydrochloride, the inhibition time (also reflecting the antioxidant content of LDL) was prolonged (P<0.001) for alpha-tocopherol (206%) and dilinoleoyl-( 188%), but not for distearoyl-phosphatidyl-choline. Thus, dilinoleoyl-phosphatidylcholine (the main component of PPC) protects against LDL oxidation, a possible mechanism for its reported anti-atherosclerosis effects. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved. C1 Bronx Vet Affairs Med Ctr, Ctr Alcohol Res & Treatment, Bronx, NY 10468 USA. Mt Sinai Sch Med, Bronx, NY 10468 USA. CUNY Hunter Coll, Nutr & Food Sci Urban Publ Hlth Program, New York, NY 10010 USA. RP Lieber, CS (reprint author), Vet Affairs Med Ctr, Alcohol Res Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. FU NIAAA NIH HHS [AA11115] NR 32 TC 18 Z9 18 U1 0 U2 0 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0021-9150 J9 ATHEROSCLEROSIS JI Atherosclerosis PD SEP PY 2000 VL 152 IS 1 BP 89 EP 95 DI 10.1016/S0021-9150(99)00454-2 PG 7 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 356MU UT WOS:000089447700011 PM 10996343 ER PT J AU Lopes-Virella, MF Koskinen, S Mironova, M Horne, D Klein, R Chassereau, C Enockson, C Virella, G AF Lopes-Virella, MF Koskinen, S Mironova, M Horne, D Klein, R Chassereau, C Enockson, C Virella, G TI The preparation of copper-oxidized LDL for the measurement of oxidized LDL antibodies by EIA SO ATHEROSCLEROSIS LA English DT Article DE arteriosclerosis; autoimmunity; autoantibodies; oxidized low-density lipoprotein antibodies; oxidized low-density lipoprotein antibody enzyme immunoassay; oxidized low-density lipoprotein ID LOW-DENSITY-LIPOPROTEIN; OXIDATIVELY-MODIFIED LDL; CAROTID ATHEROSCLEROSIS; VASCULAR-DISEASE; AUTOANTIBODIES; INVIVO AB In the present study we try to define the optimal conditions for preparation of copper-oxidized low-density lipoprotein (oxLDL) to be used for the assay of oxLDL antibodies by enzyme immunoassay (EIA). Oxidation of LDL was monitored by measuring the formation of conjugated dienes at 234 nm and the generation of fluorescent products with emission at 430 nm when excitation is performed at 360 nm. The generation of immunogenic epitopes was evaluated by testing the reactivity of aliquots collected at different times during the oxidation process with human sera with high oxLDL antibody levels and with a purified human oxLDL antibody. The values of fluorescence emission at 430 nm correlated best with reactivity with oxLDL antibodies; strong reactivity was usually associated with values greater than 1.1 U. The time needed for fluorescence emission to reach maximum levels varied between 6 and 14 h for most LDL, but it was considerably longer in a few LDL preparations. The maximal reactivity of oxLDL with oxLDL antibodies was observed when the LDL oxidation reaction was stopped 4 or more hours after the fluorescence readings reached their peak. At this stage of the oxidation reaction, apolipoprotein B fragmentation and aggregation were observed as shown by Western blot analysis. The CV for 13 EIA runs of two reference oxLDL antibodies reacting with four different pools of standardized oxLDL prepared according to the stated guidelines was 14.5 and 3.9%, confirming the reproducibility of our oxidation conditions. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved. C1 Ralph H Johnson VAMC, Dept Med, Div Endocrinol Diabet & Med Genet, Charleston, SC 29403 USA. Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. RP Lopes-Virella, MF (reprint author), Ralph H Johnson VAMC, Dept Med, Div Endocrinol Diabet & Med Genet, Strom Thurmond Bldg,Room 530,114 Doughty St,POB 2, Charleston, SC 29403 USA. FU NHLBI NIH HHS [HL-55782] NR 24 TC 20 Z9 21 U1 0 U2 1 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0021-9150 J9 ATHEROSCLEROSIS JI Atherosclerosis PD SEP PY 2000 VL 152 IS 1 BP 107 EP 115 DI 10.1016/S0021-9150(99)00456-6 PG 9 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 356MU UT WOS:000089447700013 PM 10996345 ER PT J AU Lovy, MR Starkebaum, G AF Lovy, MR Starkebaum, G TI Rheumatic disorders associated with hepatitis C SO BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY LA English DT Article DE hepatitis C; rheumatic disorders; Sjogren's syndrome; mixed cryoglobulinaemia; arthritis; liver disease; skin disorder; glomerulonephritis; neurological manifestations; dermatological manifestations; non-Hodgkin's lymphoma; serological abnormalities; diagnostic tests ID PRIMARY SJOGRENS-SYNDROME; PORPHYRIA-CUTANEA-TARDA; NON-HODGKINS-LYMPHOMA; HCV-INFECTED PATIENTS; CHRONIC LIVER-DISEASE; ORAL LICHEN-PLANUS; VIRUS CORE PROTEIN; B-CELL EXPANSIONS; MIXED CRYOGLOBULINEMIA; POLYARTERITIS-NODOSA AB The hepatitis C virus (HCV) is a common virus of world-wide distribution affecting up to 3% of the world's population. Its genetic diversity, with multiple subtypes, and existence in the form of quasispecies in individual hose, is, in part, responsible for high rates of chronic infection. Individuals with HCV infection will undoubtedly present to rheumatologists and other health care professionals with rheumatic and other immunological disorders related to what was usually a remote and asymptomatic acute infection. The goals of this review are: (I) to summarize clinical observations regarding rheumatological and immunological diseases linked with HCV infection; (2) to provide relevant information on the molecular biology of HCV; (3) to discuss the state of the art regarding the use of diagnostic studies; (4) to consider the differential diagnosis of liver disease and rheumatic disorders; and (5) to provide a practical guide to the history, physical examination, laboratory work-up, disease monitoring, and therapy of HCV patients with rheumatic disorders. C1 Univ Washington, Tacoma, WA 98405 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Seattle, WA 98108 USA. RP Lovy, MR (reprint author), Univ Washington, 1310 S Union,Suite A, Tacoma, WA 98405 USA. NR 99 TC 4 Z9 4 U1 1 U2 2 PU BAILLIERE TINDALL PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1521-6942 J9 BEST PRACT RES CL RH JI Best Pract. Res. Clin. Rheumatol. PD SEP PY 2000 VL 14 IS 3 BP 535 EP 557 DI 10.1053/berh.2000.0092 PG 23 WC Rheumatology SC Rheumatology GA 359DA UT WOS:000089595200008 PM 10985985 ER PT J AU Ahn, SC Baek, BS Oh, T Song, CS Chatterjee, B AF Ahn, SC Baek, BS Oh, T Song, CS Chatterjee, B TI Rapid mini-scale plasmid isolation for DNA sequencing and restriction mapping SO BIOTECHNIQUES LA English DT Article C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Chatterjee, B (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 5 TC 15 Z9 16 U1 0 U2 1 PU EATON PUBLISHING CO PI NATICK PA 154 E. CENTRAL ST, NATICK, MA 01760 USA SN 0736-6205 J9 BIOTECHNIQUES JI Biotechniques PD SEP PY 2000 VL 29 IS 3 BP 466 EP 468 PG 3 WC Biochemical Research Methods; Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 352DR UT WOS:000089199700011 PM 10997259 ER PT J AU Tajima, F Sato, T Lever, JH Ogawa, M AF Tajima, F Sato, T Lever, JH Ogawa, M TI CD34 expression by murine hematopoietic stem cells mobilized by granulocyte colony-stimulating factor SO BLOOD LA English DT Article ID BONE-MARROW CELLS; PERIPHERAL-BLOOD; AUTOLOGOUS TRANSPLANTATION; IN-VIVO; ANTIGEN; PROGENITOR AB Controversy has existed about CD34 expression by hematopoietic stem cells, We recently reported that CD34 expression reflects the activation state of stem cells by using a murine transplantation model. It has been generally held that mobilized blood stem cells express CD34. However, it has also been reported that mobilized stem cells and progenitors are in G0/G1 phases of the cell cycle. To address the state of CD34 expression by the mobilized stem cells, we again used the mouse transplantation model. We prepared CD34(-) and CD34(+) populations of nucleated blood cells from granulocyte colony-stimulating factor-treated Ly-5.1 mice and assayed each population for long-term engrafting cells in lethally irradiated Ly-5.2 mice, The majority of the stem cells were in the CD34(+) population. The CD34 expression by mobilized stem cells was reversible because re-transplantation of Ly-5.1 CD34(-) marrow cells harvested from the Ly-5.2 recipients of CD34(+)-mobilized stem cells 8 months posttransplantation revealed long-term engraftment These results may support the use of total CD34(+) cells in mobilized blood as a predictor for engraftment and CD34 selection for enrichment of human stem cells. (C) 2000 by The American Society of Hematology. C1 Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Dept Vet Affairs Med Ctr, Charleston, SC USA. RP Ogawa, M (reprint author), Ralph H Johnson VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. FU NCI NIH HHS [P01-CA78582]; NIDDK NIH HHS [R01-DK54197] NR 22 TC 42 Z9 45 U1 0 U2 1 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD SEP 1 PY 2000 VL 96 IS 5 BP 1989 EP 1993 PG 5 WC Hematology SC Hematology GA 358VR UT WOS:000089578300054 PM 10961905 ER PT J AU Guzman-Marin, R Alam, MN Szymusiak, R Drucker-Colin, R Gong, H McGinty, D AF Guzman-Marin, R Alam, MN Szymusiak, R Drucker-Colin, R Gong, H McGinty, D TI Discharge modulation of rat dorsal raphe neurons during sleep and waking: effects of preoptic/basal forebrain warming SO BRAIN RESEARCH LA English DT Article DE preoptic area; basal forebrain; preoptic warming; serotonergic neurons; REM-off neuron; single unit recording; rat ID EYE-MOVEMENT SLEEP; SINGLE-UNIT RESPONSES; FREELY MOVING CATS; THERMOSENSITIVE NEURONS; 5-HT1A AUTORECEPTORS; HYPOTHALAMIC NEURONS; NUCLEUS; SEROTONIN; CYCLE; WAKEFULNESS AB In cats, putative serotonergic neurons (PSNs) recorded from the dorsal raphe nucleus (DRN) across the sleep-wake cycle exhibit the so-called rapid eye movement sleep-off (REM-off) discharge pattern. Since, the sleep-wake discharge patterns of DRN neurons in behaving rats is poorly known, the present study examined this neuronal populations. The PSNs recorded in this study exhibited: (1) progressive decrease in discharge rate from waking to NREM to REM sleep; (2) long action potential duration, and (3) reduction of discharge rate after systemic administration of a selective 5-HT1A agonist, (+/-)-8-hydroxy-2-(di-n-propylamino) tetralin hydrobromide (8-OH-DPAT). Evidence supports the hypothesis that NREM sleep is modulated by thermoregulatory mechanisms localized in the preoptic area and adjacent basal forebrain (POA/BF). We previously reported that POA/BF warming suppresses the discharge of wake-promoting neurons in the posterior hypothalamus and the basal forebrain. Since the DRN is one component of the brainstem arousal system and receives projections from POA/BF, we examined the effects of local POA/BF warming by 1.5-2.0 degrees C during waking on the discharge of DRN neurons. POA/BF warming reduced the discharge in 14 of 19 PSNs and in 12 of 17 other wake-related neurons in the DRN. DRN neuronal discharge reduction occurred without accompanying EEG frequency or behavioral changes. These results suggest that PSNs recorded in DRN in unrestrained and unanesthetized rats exhibit a "wake-active REM-off" discharge pattern and further support the hypothesis that the POA/BF warm-sensitive hypnogenic system induces sleep by a coordinated inhibition of multiple arousal systems including that modulated by the DRN. (C) 2000 Elsevier Science B.V. All rights reserved. C1 Vet Affairs Greater Los Angeles Healthcare Syst, N Hills, CA 91343 USA. Univ Nacl Autonoma Mexico, Fac Med, Dept Fisiol, Mexico City 04510, DF, Mexico. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Nacl Autonoma Mexico, Inst Fisiol Celular, Dept Neurociencias, Mexico City 04510, DF, Mexico. RP McGinty, D (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, 16111 Plummer St, N Hills, CA 91343 USA. FU NHLBI NIH HHS [HL 60296]; NIMH NIH HHS [MH 47480] NR 54 TC 43 Z9 49 U1 0 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD SEP 1 PY 2000 VL 875 IS 1-2 BP 23 EP 34 DI 10.1016/S0006-8993(00)02561-0 PG 12 WC Neurosciences SC Neurosciences & Neurology GA 352DM UT WOS:000089199300003 PM 10967295 ER PT J AU Adams, SG Anzueto, A AF Adams, SG Anzueto, A TI Treating acute exacerbations of chronic bronchitis in the face of antibiotic resistance SO CLEVELAND CLINIC JOURNAL OF MEDICINE LA English DT Review ID OBSTRUCTIVE PULMONARY-DISEASE; RESPIRATORY-TRACT INFECTIONS; HAEMOPHILUS-INFLUENZAE; ANTIMICROBIAL RESISTANCE; STREPTOCOCCUS-PNEUMONIAE; UNITED-STATES; LUNG-DISEASE; CATARRHALIS; EFFICACY; THERAPY AB Antibiotics can be effective against acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease, but with bacterial resistance to multiple antibiotics increasing worldwide, appropriate antibiotic selection is critical. Categorizing patients with acute exacerbations according to age, number of exacerbations per year, disease severity, degree of pulmonary impairment, and presence of comorbid conditions helps to direct therapy. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Pulm Med & Crit Care Med, San Antonio, TX 78284 USA. RP Anzueto, A (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Mem Vet Hosp Div, Pulm Dis Sect 111E, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. NR 31 TC 4 Z9 4 U1 0 U2 1 PU CLEVELAND CLINIC PI CLEVELAND PA 9500 EUCLID AVE, CLEVELAND, OH 44106 USA SN 0891-1150 J9 CLEV CLIN J MED JI Clevel. Clin. J. Med. PD SEP PY 2000 VL 67 IS 9 BP 625 EP + PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 353EP UT WOS:000089262100005 PM 10992620 ER PT J AU Shouse, MN Farber, PR Staba, RJ AF Shouse, MN Farber, PR Staba, RJ TI Physiological basis: how NREM sleep components can promote and REM sleep components can suppress seizure discharge propagation SO CLINICAL NEUROPHYSIOLOGY LA English DT Article DE sleep; epilepsy; animal models; cats ID AMYGDALA-KINDLED KITTENS; CYCLIC ALTERNATING PATTERN; GENERALIZED EPILEPSY; CELLULAR MECHANISMS; FOCAL EPILEPSY; OSCILLATIONS; MODULATION; EEG AB Objectives: To describe how the neural generators of different sleep components can provoke seizure discharge propagation during NREM sleep and can suppress it during REM sleep. Methods: Experimental manipulations of discrete physiological components were conducted in feline epilepsy models (n = 64), mostly in the systemic penicillin epilepsy model of primary generalized epilepsy and the amygdala kindling model of the localization-related seizure disorder, temporal lobe epilepsy. Procedures included seizure induction as well as quantifying norepinephrine concentrations (microdialysis) and the sleep-waking state distribution of seizures before and after lesions, systemic and localized drug administration and/or photic stimulation. Results: (1) Neural generators of synchronous EEG oscillations, including tonic background slow waves and phasic 'arousal' events (sleep EEG transients such as sleep spindles, k-complexes), can combine to promote electrographic seizure propagation during NREM and drowsiness; anti-gravity muscle tone permits seizure-related movement. (2) Neural generators of asynchronous neuronal discharge patterns can reduce electrographic seizures during alert waking and REM sleep; skeletal motor paralysis blocks seizure-related movement during REM. (3) Etiology of the seizure disorder can interact with sleep and arousal mechanisms to determine sleep-waking state distribution of interictal and ictal events. Conclusions: Differential effects of NREM versus REM sleep components on seizure discharge propagation are to some extent non-specific and in other ways specific to seizure etiology. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved. C1 VA Greater Los Angeles Hlth Care Syst, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Dept Neurobiol, Los Angeles, CA 90024 USA. RP Shouse, MN (reprint author), 2242 S Bentley Ave 4, Los Angeles, CA 90064 USA. NR 43 TC 51 Z9 53 U1 0 U2 1 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 1388-2457 J9 CLIN NEUROPHYSIOL JI Clin. Neurophysiol. PD SEP PY 2000 VL 111 SU 2 BP S9 EP S18 DI 10.1016/S1388-2457(00)00397-7 PG 10 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 363QZ UT WOS:000089847200003 PM 10996550 ER PT J AU Chen, XM Jacobson, AF AF Chen, XM Jacobson, AF TI Nonosseous uptake on bone scan in adenocarcinoma of unknown primary origin SO CLINICAL NUCLEAR MEDICINE LA English DT Article DE adenocarcinoma; bone scan; soft tissue C1 VA Puget Sound Hlth Care Syst, Nucl Med Sect S113 NUC, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Radiol, Seattle, WA 98195 USA. RP Jacobson, AF (reprint author), VA Puget Sound Hlth Care Syst, Nucl Med Sect S113 NUC, 1660 S COlumbian Way, Seattle, WA 98108 USA. NR 4 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0363-9762 J9 CLIN NUCL MED JI Clin. Nucl. Med. PD SEP PY 2000 VL 25 IS 9 BP 751 EP 752 DI 10.1097/00003072-200009000-00030 PG 2 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 349HW UT WOS:000089040500030 PM 10983778 ER PT J AU Kaiyala, KJ Prigeon, RL Kahn, SE Woods, SC Schwartz, MW AF Kaiyala, KJ Prigeon, RL Kahn, SE Woods, SC Schwartz, MW TI Obesity induced by a high-fat diet is associated with reduced brain insulin transport in dogs SO DIABETES LA English DT Article ID CENTRAL-NERVOUS-SYSTEM; CEREBROSPINAL-FLUID; INDUCED HYPERTENSION; GLUCOSE-TOLERANCE; ZUCKER RATS; BODY-FAT; IN-VIVO; RESISTANCE; PLASMA; SENSITIVITY AB Insulin transported from plasma into the central nervous system (CNS) is hypothesized to contribute to the negative feedback regulation of body adiposity, Because CNS insulin uptake is likely mediated by insulin receptors, physiological interventions that impair insulin action in the periphery might also reduce the efficiency of CNS insulin uptake and predispose to weight gain, We hypothesized that high-fat feeding, which both reduces insulin sensitivity in peripheral tissues and favors weight gain, reduces the efficiency of insulin uptake from plasma into the CNS, To test this hypothesis, we estimated parameters for cerebrospinal fluid (CSF) insulin uptake and clearance during an intravenous insulin infusion using compartmental modeling in 10 dogs before and after 7 weeks of high-fat feeding, These parameters, together with 24-h. plasma insulin levels measured during ad libitum feeding, also permitted estimates of relative CNS insulin concentrations. The percent changes of adiposity, body weight, and food intake after high-fat feeding were each inversely associated with the percent changes of the parameter k(1)k(2), which reflects the efficiency of CNS insulin uptake from plasma (r = -0.74, -0.69, -0.63; P = 0.015, 0.03, and 0.05, respectively). These findings were supported by a non-model-based calculation of CNS insulin uptake: the CSF-to-plasma insulin ratio during the insulin infusion. This ratio changed in association with changes of k(1)k(2) (r = 0.84, P = 0.002), body weight (r = -0.66, P = 0.04), and relative adiposity (r = -0.72, P = 0.02), By comparison, changes in insulin sensitivity according to minimal model analysis, were not associated with changes in k(1)k(2), suggesting that these parameters are not regulated in parallel, During high-fat feeding, there was a 60% reduction of the estimated CNS insulin level (P = 0.04), and this estimate was inversely associated with percent: changes in body weight (r = -0.71, P = 0.03), These results demonstrate that increased food intake and weight gain during high-fat feeding are associated with and may be causally related to reduced insulin delivery into the CNS. C1 Univ Washington, Sch Dent, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Cincinnati, Dept Psychiat, Cincinnati, OH USA. RP Schwartz, MW (reprint author), Harborview Med Ctr, Box 359757,325 9th Ave, Seattle, WA USA. RI Schwartz, Michael/H-9950-2012 OI Kahn, Steven/0000-0001-7307-9002 FU NIDDK NIH HHS [DK-12829, DK-17047, DK-35816] NR 40 TC 182 Z9 187 U1 1 U2 9 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0012-1797 J9 DIABETES JI Diabetes PD SEP PY 2000 VL 49 IS 9 BP 1525 EP 1533 DI 10.2337/diabetes.49.9.1525 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 349TZ UT WOS:000089062800017 PM 10969837 ER PT J AU Boyko, EJ de Courten, M Zimmet, PZ Chitson, P Tuomilehto, J Alberti, KGMM AF Boyko, EJ de Courten, M Zimmet, PZ Chitson, P Tuomilehto, J Alberti, KGMM TI Features of the metabolic syndrome predict higher risk of diabetes and impaired glucose tolerance - A prospective study in mauritius SO DIABETES CARE LA English DT Article ID INSULIN-RESISTANCE; CARDIOVASCULAR RISK; CHINESE MAURITIANS; PLASMA LEPTIN; FOLLOW-UP; AFRICAN-AMERICANS; BASE-LINE; MELLITUS; MEN; POPULATION AB OBJECTIVE - To assess the independent and joint effects of the components of the metabolic syndrome, including leptin, which is a recently proposed addition to this syndrome, in predicting the cumulative incidence of impaired glucose tolerance (IGT) and diabetes among individuals with normal glucose tolerance. RESEARCH DESIGN AND METHODS - This prospective study involved 2,605 residents of Mauritius with normal glucose tolerance who were followed for 5 years for IGT or diabetes onset in relation to total and regional adiposity (BMI, waist-to-hip ratio [WHR]), fasting and 2-h 75-g oral glucose load glucose and insulin, total and HDL cholesterol, blood pressure, serum uric acid, triglyceride, and leptin levels. RESULTS - A multivariate logistic regression model adjusted for age, sex, ethnicity and diabetes family history showed a significantly higher linear increase in risk of IGT and diabetes in association with the following variables only: lasting glucose (odds ratio 1.89 [95% CI 1.51-2.34]), 2-h glucose (1.68 [1.50-1.88]), WHR (1.30 [1.10-1.52]), BMI (1.04 [1.00-1.08]), and serum uric acid (1.37 [1.20-1.57]). However, a nonlinear increase was seen with serum triglyceride and plasma leptin concentrations. No risk factors resulted in joint effects that were greater than expected from combining individual effects. CONCLUSIONS - Metabolic syndrome features independently predict a higher risk of diabetes or IGT in normoglycemic subjects bur in combination confer no higher-than-expected risk of these outcomes. At higher concentrations of triglycerides and leptin, risk plateaus and even declines slightly. C1 Int Diabet Inst, Melbourne, Vic, Australia. Vet Affairs Puget Sound, Epidemiol Res & Informat Ctr, Seattle, WA USA. Minist Hlth, Port Louis, Mauritius. Natl Publ Hlth Inst, Dept Epidemiol & Hlth Promot, Helsinki, Finland. Univ Newcastle Upon Tyne, Human Diabet & Metab Res Ctr, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England. RP Boyko, EJ (reprint author), Vet Affairs Med Ctr, 1660 S Columbian Way, Seattle, WA 98108 USA. OI Boyko, Edward/0000-0002-3695-192X FU NIDDK NIH HHS [DK-25446] NR 35 TC 62 Z9 69 U1 0 U2 2 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD SEP PY 2000 VL 23 IS 9 BP 1242 EP 1248 DI 10.2337/diacare.23.9.1242 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 348UT UT WOS:000089005400007 PM 10977013 ER PT J AU Boyko, EJ AF Boyko, EJ TI Proportion of type 2 diabetes cases resulting from impaired fetal growth SO DIABETES CARE LA English DT Article ID THRIFTY PHENOTYPE HYPOTHESIS; BIRTH-WEIGHT; GLUCOSE-TOLERANCE; ATTRIBUTABLE RISK; MEN; MELLITUS; EXPOSURE; DISEASE; POPULATION; ADULTS AB OBJECTIVE - During the past decade, several researchers have demonstrated a higher risk of type 2 diabetes in relation to lower birth weight. This theory, referred to as the "thrifty phenotype'' hypothesis, postulates that impaired fetal growth predisposes individuals to the development of diabetes and other metabolic abnormalities. This article examines the importance of fetal growth in the etiology of diabetes by estimating the proportion of diabetes cases associated with this exposure. RESEARCH DESIGN AND METHODS - The importance of an exposure or its correlate as a potential cause of a disease can be assessed by estimating the proportion of cases that could he prevented if the exposure was eliminated from a defined population. This proportion is referred to as the population-attributable fraction (PAF). Published studies of the association between diabetes and birth weight were reviewed and selected for further analysis if data were presented that enabled PAP calculation. In addition, PAFs were calculated for higher birth weight cutoffs because researchers have postulated that the lowest birth weight category may not capture all cases of fetal growth retardation. Studies have shown that exposure classified in this broader manner can produce unbiased PAP estimates, even if many subjects are falsely classified as exposed. RESULTS - PAFs for the lowest birth weight category ranged from 0.01 to 0.25. In this analysis, PAFs for diabetes did not exceed 0.35. In contrast, >50% of diabetes cases in the First National Health and Nutrition Examination Survey Epidemiologic Follow-Up Study were attributable to excess adiposity as reflected by a BMI of greater than or equal to 26 kg/m(2) (PAF >0.50). CONCLUSIONS - Impaired fetal growth or its correlates account for a minority (<0.50) of type 2 diabetes cases. C1 Vet Affairs Puget Sound Hlth Care Syst, Vet Affairs Epidemiol Res & Informat Ctr, Seattle, WA USA. RP Boyko, EJ (reprint author), Vet Affairs Med Ctr, 1660 S Columbian Way, Seattle, WA 98108 USA. OI Boyko, Edward/0000-0002-3695-192X FU NIDDK NIH HHS [DK-48152, DK-31170, DK-43134] NR 26 TC 30 Z9 30 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD SEP PY 2000 VL 23 IS 9 BP 1260 EP 1264 DI 10.2337/diacare.23.9.1260 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 348UT UT WOS:000089005400010 PM 10977016 ER PT J AU Lipsky, BA Berendt, AR AF Lipsky, BA Berendt, AR TI Principles and practice of antibiotic therapy of diabetic foot infections SO DIABETES-METABOLISM RESEARCH AND REVIEWS LA English DT Article; Proceedings Paper CT 3rd International Symposium on the Diabetic Foot CY MAY 05-08, 1999 CL NOORDWIJKERHOUT, NETHERLANDS DE foot infections; osteomyelitis; antibiotic therapy; diabetic foot ID CONTROLLED TRIAL; OSTEOMYELITIS; ULCERS; MANAGEMENT; AMPUTATION AB Foot infections are a common and serious problem in diabetic patients. They usually occur as a consequence of a skin ulceration, which initially is colonized with normal flora, and later infected with pathogens. Infection is defined clinically by evidence of inflammation, and appropriate cultures can determine the microbial etiology. Aerobic gram-positive cocci are the most important pathogens; in chronic, complex or previously treated wounds, gram-negative bacilli and anaerobes may join in a polymicrobial infection. In all diabetic foot infections a primary consideration is whether or not surgical intervention is required, e.g. for undrained pus, wound debridement or revascularization. Antibiotic regimens are usually selected empirically initially, then modified if needed based on results of culture and sensitivity tests and the patient's clinical response. Initial therapy especially in serious infections, may need to be broad-spectrum, but definitive therapy can often be more targeted. Severe infections usually require intravenous therapy initially, but milder cases can be treated with oral agents. Treatment duration ranges from 1-2 weeks (for mild soft tissue infection) to more than 6 weeks (for osteomyelitis). The choice of a specific agent should be based on the usual microbiology of these infections, data from published clinical trials, the severity of the patient's infection, and the culture results. Extension of infection into underlying bone can be difficult to diagnose and may require imaging tests, e.g. magnetic resonance scans. Cure of osteomyelitis usually requires resection of infected bone, but can be accomplished with prolonged antibiotic therapy. Various non-antimicrobial adjunct therapies may sometimes be helpful. Published in 2000 by John Wiley & Sons, Ltd. C1 Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Gen Internal Med Clin, Seattle, WA 98108 USA. Univ Oxford, Oxford, England. RP Lipsky, BA (reprint author), Univ Washington, Sch Med, VA Puget Sound Hlth Care Syst, Gen Internal Med Clin, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 23 TC 51 Z9 51 U1 0 U2 3 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 1520-7552 J9 DIABETES METAB RES JI Diabetes-Metab. Res. Rev. PD SEP-OCT PY 2000 VL 16 SU 1 BP S42 EP S46 DI 10.1002/1520-7560(200009/10)16:1+<::AID-DMRR109>3.3.CO;2-2 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 369NB UT WOS:000165071300010 PM 11054887 ER PT J AU Guarita, DR Deng, X Huh, YB Wood, PG Reeve, JR Whitcomb, DC AF Guarita, DR Deng, X Huh, YB Wood, PG Reeve, JR Whitcomb, DC TI PYY regulates pancreatic exocrine secretion through multiple receptors in the awake rat SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE gut-brain axis; brain stem; dorsal vagal complex; Y receptor ID DORSAL VAGAL COMPLEX; PEPTIDE YY PYY; NEUROPEPTIDE-Y; RELEASE; DOG; RADIOIMMUNOASSAY; CHOLECYSTOKININ; LOCALIZATION; STIMULATION; INHIBITION AB Peptide YY (PYY) is one of several regulatory peptides reported to modulate pancreatic secretion. PYY circulates in two forms, PYY1-36 and PYY3-36 and binds to multiple receptor subtypes. We sought to determine if PYY1-36 or PYY3-36 regulates neurally mediated pancreatic secretion through the Y1, Y2, and/or Y5 receptor subtypes. Experiments were conducted in awake, surgically recovered rats. In order to determine the effects of the PYYs on basal pancreatic secretion, either PYY1-36, [pro(34)] PYY1-36 (a Y1/Y5 agonist), or PYY3-36 (a Y2/Y5 agonist) were infused for 40 min at doses of 0, 12.5, 25, or 50 pmol/kg/hr while measuring pancreatic juice volume and protein. PYY1-36 increased pancreatic protein secretion at 25 and 50 pmol/kg/hr (P < 0.05) in a dose-dependent manner (P < 0.001, R-2 = 0.990). The Y2/Y5 receptor agonist PYY3-36 significantly inhibited pancreatic juice volume and protein at 12.5 and 25 pmol/kg/hr, but stimulated protein secretion at higher doses (P < 0.001, R-2 = 0.995). The Y1/Y5 agonist,[Pro(34)] PYY1-36, had no significant effect on basal pancreatic exocrine secretion. Therefore, PYY1-36 PYY3-36 and [Pro(34)] PYY1-36 produced different, dose-dependent changes on basal pancreatic exocrine secretion. Inhibition of pancreatic secretion by circulating PYY1-36 and PYY3-36 are primarily mediated by the Y2 receptor. Since [Pro(34)] PYY1-36 did not change pancreatic secretion, it can be concluded that circulating PYY1-36 or PYY3-36 does not modulate pancreatic secretion through the Y1 or Y5 receptors. Since the stimulatory effects of PYY1-36 on pancreatic secretion could not be explained by the actions of PYY3-36 or [Pro(34)] PYY1-36 on Y1 or Y2 receptors, and since PYY1-36 fails to bind to Y3 or Y4 receptors, we also conclude that PYY1-36 may stimulate pancreatic secretion in a dose-dependent mechanism through a PYY receptor subtype different from Y1, Y2, Y3, Y4 or Y5. C1 Univ Pittsburgh, Dept Med, Div Gastroenterol & Hepatol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Dept Cell Biol & Physiol, Pittsburgh, PA 15261 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Hlth Care Syst, CURE, Digest Dis Res Ctr, Los Angeles, CA USA. Pittsburgh Vet Affairs Med Ctr, Pittsburgh, PA USA. RP Whitcomb, DC (reprint author), Univ Pittsburgh, Dept Med, Div Gastroenterol & Hepatol, 571 Scaife Hall,3550 Terrace St, Pittsburgh, PA 15261 USA. FU NIDDK NIH HHS [R01 DK50236, DK 41301, R29 DK45781] NR 33 TC 13 Z9 13 U1 0 U2 2 PU KLUWER ACADEMIC/PLENUM PUBL PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD SEP PY 2000 VL 45 IS 9 BP 1696 EP 1702 DI 10.1023/A:1005550732146 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 365TH UT WOS:000089966200002 PM 11052307 ER PT J AU Li, QL Jansen, E Brent, GA Naqvi, S Wilber, JF Friedman, TC AF Li, QL Jansen, E Brent, GA Naqvi, S Wilber, JF Friedman, TC TI Interactions between the prohormone convertase 2 promoter and the thyroid hormone receptor SO ENDOCRINOLOGY LA English DT Article ID RETINOID-X-RECEPTOR; VASOACTIVE INTESTINAL PEPTIDE; MESSENGER-RNA EXPRESSION; CAMP RESPONSE ELEMENTS; ANTERIOR-PITUITARY; PROPROTEIN CONVERTASE; NEGATIVE REGULATION; GENE-EXPRESSION; CHROMOSOMAL LOCALIZATION; NEUROENDOCRINE TISSUES AB The majority of prohormones are cleaved at paired basic residues to generate bioactive hormones by prohormone convertases (PCs). As PC1 and PC2, two neuroendocrine-specific PCs, appear to be the key enzymes capable of processing a variety of prohormones, alterations of PC2 and/or PC1 levels will probably have a profound effect on hormonal homeostasis. We investigated the regulation of PC2 messenger RNA (mRNA) by thyroid hormone using GH(3) cells to demonstrate that T-3 negatively regulated PC2 mRNA levels in a dose- and time-dependent fashion. Functional analysis of progressive 5'-deletions of the human (h) PC2 promoter luciferase constructs in GH, cells demonstrated that the regulation probably occurs at the transcriptional level, and that putative negative thyroid hormone response elements were located within the region from -44 to +137 bp relative to the transcriptional start site. Transient transfections in JEG-3 cells and COS-1 cells showed that the suppressive effect of T-3 was equally mediated by the thyroid hormone receptor (TR) isoforms TR alpha 1 and TR beta 1. Electrophoretic mobility shift assays using purified TR alpha 1 and retinoid X receptor-beta protein as well as GH(3) nuclear extracts showed that regions from +51 to +71 bp and from +118 to +137 bp of the hPC2 promoter bind to TR alpha 1 as both a monomer and a homodimer and with TR alpha 1/retinoid X receptor-beta as a heterodimer. Finally, the in vivo regulation of pituitary PC2 mRNA by thyroid status was demonstrated in rats. These results demonstrate that T-3 negatively regulates PC2 expression at the transcriptional level and that functional negative thyroid hormone response elements exist in the hPC2 promoter. We postulate that the alterations of PC2 activity may mediate some of the pathophysiological consequences of hypo- or hyperthyroidism. C1 Univ Calif Los Angeles, Cedars Sinai Med Ctr, Sch Med, Dept Med,Div Endocrinol, Los Angeles, CA 90048 USA. Catholic Univ Louvain, Ctr Human Genet, Mol Oncol Lab, B-3000 Louvain, Belgium. Flanders Interuniv Inst Biotechnol, B-3000 Louvain, Belgium. W Los Angeles Vet Affairs Med Ctr, Dept Med, Div Endocrinol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Physiol, Los Angeles, CA 90073 USA. Univ Maryland, Dept Med, Div Endocrinol & Metab, Baltimore, MD 21201 USA. RP Univ Calif Los Angeles, Charles R Drew Univ Med & Sci, Div Endocrinol, 1721 E 120th St, Los Angeles, CA 90059 USA. EM friedman@hotmail.com FU NIDA NIH HHS [DA-00276]; NIDDK NIH HHS [DK-43714, DK-287235] NR 87 TC 16 Z9 16 U1 0 U2 1 PU ENDOCRINE SOC PI WASHINGTON PA 2055 L ST NW, SUITE 600, WASHINGTON, DC 20036 USA SN 0013-7227 EI 1945-7170 J9 ENDOCRINOLOGY JI Endocrinology PD SEP PY 2000 VL 141 IS 9 BP 3256 EP 3266 DI 10.1210/en.141.9.3256 PG 11 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 346LE UT WOS:000088872200026 PM 10965896 ER PT J AU DeGiorgio, CM Schachter, SC Handforth, A Salinsky, M Thompson, J Uthman, B Reed, R Collins, S Tecoma, E Morris, GL Vaughn, B Naritoku, DK Henry, T Labar, D Gilmartin, R Labiner, D Osorio, I Ristanovic, R Jones, J Murphy, J Ney, G Wheless, J Lewis, P Heck, C AF DeGiorgio, CM Schachter, SC Handforth, A Salinsky, M Thompson, J Uthman, B Reed, R Collins, S Tecoma, E Morris, GL Vaughn, B Naritoku, DK Henry, T Labar, D Gilmartin, R Labiner, D Osorio, I Ristanovic, R Jones, J Murphy, J Ney, G Wheless, J Lewis, P Heck, C TI Prospective long-term study of vagus nerve stimulation for the treatment of refractory seizures SO EPILEPSIA LA English DT Article; Proceedings Paper CT 51st Annual Meeting of the American-Academy-of-Neurology CY APR 17-24, 1999 CL TORONTO, CANADA SP Amer Acad Neurol DE vagus nerve stimulation; intractable epilepsy ID VAGAL-STIMULATION; EPILEPSY; TRIAL AB Purpose: To determine the long-term efficacy of vagus nerve stimulation (VNS) for refractory seizures. VNS is a new treatment for refractory epilepsy. Two short-term double-blind trials have demonstrated its safety and efficacy, and one long-term study in 114 patients has demonstrated a cumulative improvement in efficacy at 1 year. We report the largest prospective long-term study of VNS to date. Methods: Patients with six or more complex partial or generalized tonic-clonic seizures enrolled in the pivotal EO5 study were prospectively evaluated for 12 months. The primary outcome variable was the percentage reduction in total seizure frequency at 3 and 12 months after completion of the acute EO5 trial, compared with the preimplantation baseline. Subjects originally randomized to low stimulation (active-control group) were crossed over to therapeutic stimulation settings for the first time. Subjects initially randomized to high settings were maintained on high settings throughout the 12-month study. Results: The median reduction at 12 months after completion of the initial double-blind study was 45%. At 12 months, 35% of 195 subjects had a >50% reduction in seizures, and 20% of 195 had a >75% reduction in seizures. Conclusions: The efficacy of VNS improves during 12 months, and many subjects sustain >75% reductions in seizures. C1 Olive View UCLA Med Ctr, Sylmar, CA 91342 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA. Harvard Univ, Sch Med, Boston, MA USA. USC, Dept Neurol, Houston, TX USA. Synergos Consultants Biomed Res, Houston, TX USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Univ N Carolina, Chapel Hill, NC USA. DVA, Gainesville, FL USA. Univ Florida, Gainesville, FL USA. So Illinois Univ, Springfield, IL USA. UC San Diego, La Jolla, CA USA. Emory Univ, Atlanta, GA 30322 USA. Case Western Reserve Univ, Cleveland, OH 44106 USA. Res Inst Kansas, Wichita, KS USA. Cornell Univ, New York, NY USA. Med Coll Wisconsin, Milwaukee, WI 53226 USA. Univ Kansas, Kansas City, KS USA. Rush Presbyterian St Lukes Med Ctr, Chicago, IL 60612 USA. Univ Arizona, Tucson, AZ USA. Univ Wisconsin, Madison, WI USA. Childrens Mercy Hosp, Kansas City, KS USA. Long Isl Jewish Hosp, New Hyde Park, NY USA. Univ Texas, Houston, TX USA. W Los Angeles VA, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Hosp Cleveland, Cleveland, OH 44106 USA. RP DeGiorgio, CM (reprint author), Olive View UCLA Med Ctr, 14445 Olive View Dr, Sylmar, CA 91342 USA. OI Henry, Thomas/0000-0002-5708-903X NR 17 TC 245 Z9 250 U1 3 U2 12 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD SEP PY 2000 VL 41 IS 9 BP 1195 EP 1200 DI 10.1111/j.1528-1157.2000.tb00325.x PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 350YA UT WOS:000089128200014 PM 10999559 ER PT J AU Weiss, T Miltner, WHR Huonker, R Friedel, R Schmidt, I Taub, E AF Weiss, T Miltner, WHR Huonker, R Friedel, R Schmidt, I Taub, E TI Rapid functional plasticity of the somatosensory cortex after finger amputation SO EXPERIMENTAL BRAIN RESEARCH LA English DT Article DE phantom limb; cortical reorganization; magnetoencephalography; somatosensory evoked magnetic fields (SEF) ID PHANTOM-LIMB PAIN; CORTICAL REORGANIZATION; DIGIT DENERVATION; MACAQUE MONKEYS; IMMEDIATE; INJURY; HUMANS; NERVE; MAPS; REPRESENTATION AB Recent research indicates that areas of the primary somatosensory (SI) and primary motor cortex show massive cortical reorganization after amputation of the upper arm, forearm or fingers. Most of these studies were carried out months or several years after amputation. In the present study, we describe cortical reorganization of areas in the SI of a patient who underwent amputation of the traumatized middle and ring fingers of his right hand 10 days before cortical magnetic source imaging data were obtained. Somatosensory-evoked;ed magnetic fields (SEF) to mechanical stimuli to the finger tips were recorded and single moving dipoles were calculated using a realistic volume conductor model. Results reveal that the dipoles representing the second and fifth fingers of the affected hand were closer together than the comparable dipoles of the unaffected hand. Our findings demonstrate that neural cell assemblies in SI which formerly represented the right middle and ring fingers of this amputee became reorganized and invaded by neighbouring cell assemblies of the index and little finger of the same hand. These results indicate that functional plasticity occurs within a period of 10 days after amputation. C1 Univ Jena, Dept Biol & Clin Psychol, D-07743 Jena, Germany. Univ Jena, Ctr Biomat, D-077401 Jena, Germany. Univ Jena, Dept Surg, D-07740 Jena, Germany. Univ Alabama, Dept Psychol, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Phys Med & Rehabil Serv, Birmingham, AL 35233 USA. RP Miltner, WHR (reprint author), Univ Jena, Dept Biol & Clin Psychol, Steiger 3,Haus 1, D-07743 Jena, Germany. EM miltner@biopsy.uni-jena.de NR 38 TC 60 Z9 64 U1 7 U2 16 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0014-4819 J9 EXP BRAIN RES JI Exp. Brain Res. PD SEP PY 2000 VL 134 IS 2 BP 199 EP 203 DI 10.1007/s002210000456 PG 5 WC Neurosciences SC Neurosciences & Neurology GA 354PV UT WOS:000089339600007 PM 11037286 ER PT J AU Zainal, TA Oberley, TD Allison, DB Szweda, LI Weindruch, R AF Zainal, TA Oberley, TD Allison, DB Szweda, LI Weindruch, R TI Caloric restriction of rhesus monkeys lowers oxidative damage in skeletal muscle SO FASEB JOURNAL LA English DT Article DE aging; free radicals; immunogold; lipid peroxidation; reactive oxygen species; sarcopenia ID PROTEIN-TURNOVER; DIETARY RESTRICTION; SARCOPLASMIC-RETICULUM; TYROSINE NITRATION; SERCA2A ISOFORM; NITRIC-OXIDE; CA-ATPASE; RAT; GROWTH; ANTIOXIDANT AB In laboratory rodents, caloric restriction (CR) retards several age-dependent physiological and biochemical changes in skeletal muscle, including increased steady-state levels of oxidative damage to lipids, DNA, and proteins. We used immunogold electron microscopic (EM) techniques with antibodies raised against 4-hydroxy-2-nonenal (HNE) -modified proteins, dinitrophenol, and nitrotyrosine to quantify and localize the age-dependent accrual of oxidative damage in rhesus monkey vastus lateralis skeletal muscle, Using immunogold EM analysis of muscle from rhesus monkeys ranging in age from 2 to 34 years old, a fourfold maximal increase in levels of HNE-modified proteins was observed. Likewise, carbonyl levels increased twofold with aging, Comparing 17- to 23-year-old normally fed to age-matched monkeys subjected to CR for 10 years, levels of HNE-modified proteins, carbonyls, and nitrotyrosine in skeletal muscle from the CR group were significantly less than control group values. Oxidative damage largely localized to myofibrils, with lesser labeling in other subcellular compartments. Accumulation of lipid peroxidation-derived aldehydes, such as malondialdehyde and 4-hydroxy-2-alkenals, and protein carbonyls were measured biochemically and confirmed the morphological data. Our study is the first to quantify morphologically and localize the age-dependent accrual of oxidative damage in mammalian skeletal muscle and to demonstrate that oxidative damage in primates is lowered by CR. C1 William S Middleton Mem Vet Hosp, Pathol & Lab Med Serv, Madison, WI 53705 USA. William S Middleton Mem Vet Hosp, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. Univ Wisconsin, Dept Nutr Sci, Madison, WI 53705 USA. Univ Wisconsin, Dept Lab Med & Pathol, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Madison, WI 53705 USA. Univ Wisconsin, Wisconsin Reg Primate Res Ctr, Madison, WI 53705 USA. Columbia Univ Coll Phys & Surg, St Lukes Roosevelt Hosp, Obes Res Ctr, New York, NY 10032 USA. Case Western Reserve Univ, Sch Med, Dept Physiol & Biophys, Cleveland, OH 44106 USA. RP Oberley, TD (reprint author), William S Middleton Mem Vet Hosp, Pathol & Lab Med Serv, 2500 Overlook Terrace,Room A35, Madison, WI 53705 USA. OI Allison, David/0000-0003-3566-9399 NR 56 TC 131 Z9 141 U1 3 U2 9 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD SEP PY 2000 VL 14 IS 12 BP 1825 EP 1836 DI 10.1096/fj.99-0881com PG 12 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 352JU UT WOS:000089212400022 PM 10973932 ER PT J AU Pfutzer, RH Barmada, MM Brunskill, APJ Finch, R Hart, PS Neoptolemos, J Furey, WF Whitcomb, DC AF Pfutzer, RH Barmada, MM Brunskill, APJ Finch, R Hart, PS Neoptolemos, J Furey, WF Whitcomb, DC TI SPINK1/PSTI polymorphisms act as disease modifiers in familial and idiopathic chronic pancreatitis SO GASTROENTEROLOGY LA English DT Article ID SECRETORY TRYPSIN-INHIBITOR; CYSTIC-FIBROSIS GENE; HEREDITARY PANCREATITIS; 3-DIMENSIONAL STRUCTURE; LINKAGE ANALYSIS; KAZAL-TYPE; MUTATIONS AB Background & Aims: Gain-of-function trypsin mutations cause acute pancreatitis and chronic pancreatitis. Loss of trypsin inhibitor function may have similar effects. We investigated the prevalence of SPINK1 (PSTI) mutations in familial pancreatitis, idiopathic chronic pancreatitis, and controls. Methods: Genetic-linkage studies were performed in 5 familiar pancreatitis families. The entire SPINK1 gene was sequenced in 112 affected individuals and 95 control DNA samples, and exon 3 was sequenced in 95 additional controls. X-ray crystallography- based model building and statistical studies were performed. Results: Significant linkage between pancreatitis and 5q31.1-2 was excluded. Novel SPINK1 mutations, one D50E mutation, one IVS3+125 C>A, and five IVS3+184 T>A intronic polymorphisms were identified. The N34S and P55S mutations were observed in 29 of 112 patients (25%) as N34S/N34S (n = 7), N34S/wt (n = 19), N34S/P55S (n = 2), and N34S/D50E (n = 1). Three hundred eighty control alleles revealed 3 N34S (0.77%), 2 P55S (0.53%), and no D50E mutations. Age of disease onset and severity were similar between homozygous and heterozygous patients. Structural modeling revealed several possible pathophysiologic mechanisms for the N34S mutation. Conclusions: SPINK1 mutations are common in the population (similar to 2%), but are clearly associated with pancreatitis. The mutation-associated risk is low. Modeling and familial clustering suggest that SPINK1 mutations are disease modifying, possibly by lowering the threshold for pancreatitis from other genetic or environmental factors, but by themselves do not cause disease. C1 Univ Pittsburgh, Dept Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Human Genet, Pittsburgh, PA USA. Univ Pittsburgh, Dept Cell Biol & Physiol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Pharmacol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Ctr Genom Sci, Pittsburgh, PA USA. VA Pittsburgh Hlth Care Syst, Biocrystallog Lab, Pittsburgh, PA USA. VA Pittsburgh Hlth Care Syst, Div Gastroenterol, Pittsburgh, PA USA. Univ Liverpool, Dept Surg, Liverpool L69 3BX, Merseyside, England. RP Whitcomb, DC (reprint author), Univ Pittsburgh, Dept Med, 930 Scaife Hall, Pittsburgh, PA 15260 USA. RI Neoptolemos, John/G-4488-2010 OI Barmada, M Michael/0000-0002-3604-6460 FU NIDDK NIH HHS [DK54709] NR 42 TC 309 Z9 314 U1 1 U2 11 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD SEP PY 2000 VL 119 IS 3 BP 615 EP 623 DI 10.1053/gast.2000.18017 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 350ED UT WOS:000089087000007 PM 10982753 ER PT J AU Gralnek, IM Hays, RD Kilbourne, A Naliboff, B Mayer, EA AF Gralnek, IM Hays, RD Kilbourne, A Naliboff, B Mayer, EA TI The impact of irritable bowel syndrome on health-related quality of life SO GASTROENTEROLOGY LA English DT Article ID OF-LIFE; CLINICAL-TRIALS; UNITED-STATES; PATIENT OUTCOMES; MEDICAL OUTCOMES; SURVEY SF-36; DISEASE; INSTRUMENT; DISORDERS; SYMPTOMS AB Background & Aims: Few data are available to evaluate health-related quality of life (HRQOL) of people with irritable bower syndrome (IBS), We evaluated and compared the impact of IBS on HRQOL using previously reported HRQOL data for the U.S. general population and for people with selected chronic diseases. Methods: Using the SF-36 Health Survey, we compared the HRQOL of IBS patients (n = 877) with previously reported SF-36 data for the general U.S. population and for patients with gastroesophageal reflux disease (GERD), diabetes mellitus, depression, and dialysis-dependent end-stage renal disease (ESRD). Results: On all 8 SF-36 scales, IBS patients had significantly worse HRQOL than the U.S. general population (P < 0.001). Compared with GERD patients, IBS patients scored significantly lower on all SF-36 scales (P < 0.001) except physical functioning. Similarly, IBS patients had significantly worse HRQOL on selected SF-36 scales than patients with diabetes mellitus and ESRD. IBS patients had significantly better mental health SF-36 scale scores than patients with depression (P < 0.001), Conclusions: IBS patients experience significant impairment in HRQOL. Decrements in HRQOL are most pronounced in energy/fatigue, role limitations caused by physical health problems, bodily pain, and general health perceptions. These data offer further insight into the impact of IBS on patient functional status and well-being. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Gen Internal Med Hlth Serv Res, Los Angeles, CA 90024 USA. CURE, Digest Dis Res Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Study Digest Hlth Care Qual & Outcomes, Los Angeles, CA USA. RAND, Santa Monica, CA USA. VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. Univ Calif Los Angeles, Neuroenter Dis Program, Los Angeles, CA USA. RP Gralnek, IM (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd,CURE Bldg 115,Room 318, Los Angeles, CA 90073 USA. RI Hays, Ronald/D-5629-2013 NR 44 TC 332 Z9 347 U1 6 U2 20 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD SEP PY 2000 VL 119 IS 3 BP 654 EP 660 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 350ED UT WOS:000089087000012 PM 10982758 ER PT J AU Marro, ML Scremin, OU Jordan, MC Huynh, L Porro, F Roos, KP Gajovic, S Baralle, FE Muro, AF AF Marro, ML Scremin, OU Jordan, MC Huynh, L Porro, F Roos, KP Gajovic, S Baralle, FE Muro, AF TI Hypertension in beta-adducin-deficient mice SO HYPERTENSION LA English DT Article DE hypertension, genetic; adducin; mice, knockout; echocardiography; cytoskeleton; telemetry; electrocardiography ID HUMAN ALPHA-ADDUCIN; BLOOD-PRESSURE; GENETIC-HYPERTENSION; JAPANESE POPULATION; POINT MUTATIONS; POLYMORPHISM; ASSOCIATION; PROTEIN; LINKAGE; LOCUS AB Polymorphic variants of the cytoskeletal protein adducin have been associated with hypertension in humans and rats. However, the direct role of this protein in modulating arterial blood pressure has never been demonstrated. To assess the effect of beta-adducin on blood pressure, a beta-adducin-deficient mouse strain (-/-) was studied and compared with wild-type controls (+/+). Aortic blood pressure was measured in nonanesthetized, freely moving animals with the use of telemetry implants. It is important to note that these mice have at least 98% of C57B1/6 genetic background, with the only difference from wild-type animals being the beta-adducin mutation. We found statistically significant higher levels of systolic blood pressure (mm Hg) (mean+/-SE values: -/-: 126.94+/-1.14, n=5; +/+: 108.06+/-2.34, n=6; P less than or equal to 0.0001), diastolic blood pressure (-/-: 83.54+/-1.07; +/+: 74.87+/-2.23; P less than or equal to 0.005), and pulse blood pressure (-/-: 43.32+/-1.10; +/+: 33.19+/-1.96; P less than or equal to 0.001) in beta-adducin-deficient mice. Western blot analysis showed that as a result of the introduced genetic modification, beta-adducin was not present in heart protein extracts from -/- mice. Consequently, this deficiency produced a sharp decrease of alpha-adducin and a lesser reduction in gamma-adducin levels. However, we found neither cardiac remodeling nor modification of the heart function in these animals. This is the first report showing direct evidence that hypertension is triggered by a mutation in the adducin gene family. C1 Int Ctr Genet Engn & Biotechnol, I-34012 Trieste, Italy. Univ Calif Los Angeles, Sch Med, Dept Physiol, Los Angeles, CA 90024 USA. Vet Affairs GLA Healthcare Syst, Los Angeles, CA USA. Univ Zagreb, Sch Med, Dept Histol & Embryol, Zagreb 41001, Croatia. RP Muro, AF (reprint author), Int Ctr Genet Engn & Biotechnol, Padriciano 99, I-34012 Trieste, Italy. RI Muro, Andres/K-3156-2016 OI Muro, Andres/0000-0002-9628-0494 NR 24 TC 28 Z9 28 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0194-911X J9 HYPERTENSION JI Hypertension PD SEP PY 2000 VL 36 IS 3 BP 449 EP 453 PG 5 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 354MG UT WOS:000089333800025 PM 10988280 ER PT J AU VanSickle, DP Cooper, RA Boninger, ML AF VanSickle, DP Cooper, RA Boninger, ML TI Road loads acting on manual wheelchairs SO IEEE TRANSACTIONS ON REHABILITATION ENGINEERING LA English DT Article DE design; forces; instrumentation; modeling; moments; wheelchairs ID SURFACE; DESIGN AB A barrier to performing more in-depth analyzes during the wheelchair design process is a lack of dynamic reaction force and moment data, and the instrumentation to collect this data. Instrumentation was developed to collect the dynamic force and moment data. New data collections methodologies and analysis techniques were implemented to facilitate computer-aided-engineering fur wheelchair designs. Data were collected during standardized wheelchair fatigue tests, while driving over a simulated road course within a laboratory, and while driving in the community. Seventeen subjects participated in this study. Based upon the three test conditions, a pseudo-statistical distribution of the force and moment data at both a easter and rear wheel was developed. The key parameters describing the distribution and the extremums of the data (minima and maxima) were compared using analysis of variance. The results showed that the force and moment distributions and extreme values were similar for the both sets of human trials (i.e,, simulated road course and field trials). However, the standardized testing (i.e., wheelchair fatigue testing) differed from both human trials. The force/moment data gathered during this study are suitable for inputs in finite element analysis and dynamic modeling. Our results suggest that the fatigue tests should be modified to change the magnitude and increase the frequency of the forces and moments imparted on the wheelchair. The data reported from this study can be used to improve wheelchair standards and to facilitate computer-aided-engineer in wheelchair design. C1 VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Human Engn Res Labs, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Med Ctr, Div PM&R, Pittsburgh, PA 15261 USA. RP VanSickle, DP (reprint author), VA Pittsburgh Healthcare Syst, VA Rehabil Res & Dev Ctr, Human Engn Res Labs, Pittsburgh, PA 15206 USA. OI Boninger, Michael/0000-0001-6966-919X NR 33 TC 14 Z9 14 U1 1 U2 2 PU IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC PI NEW YORK PA 345 E 47TH ST, NEW YORK, NY 10017-2394 USA SN 1063-6528 J9 IEEE T REHABIL ENG JI IEEE Trans. Rehabil. Eng. PD SEP PY 2000 VL 8 IS 3 BP 371 EP 384 DI 10.1109/86.867879 PG 14 WC Engineering, Biomedical; Rehabilitation SC Engineering; Rehabilitation GA 354NN UT WOS:000089336700012 PM 11001517 ER PT J AU DiGiovine, CP Cooper, RA DiGiovine, MM Boninger, ML Robertson, RN AF DiGiovine, CP Cooper, RA DiGiovine, MM Boninger, ML Robertson, RN TI Frequency analysis of kinematics of racing wheelchair propulsion SO IEEE TRANSACTIONS ON REHABILITATION ENGINEERING LA English DT Article DE cutoff frequency; frequency analysis; kinematics; motion analysis; racing wheelchair propulsion ID SPINAL-CORD INJURY; ERGOMETER; EFFICIENCY; CHILDREN; ADULTS AB The purpose of this study was to describe the frequency content of racing wheelchair propulsion motion data. The selection of the filter corner frequency in previous kinematic analyses of manual wheelchair propulsion was commonly based on gait literature. An estimate of the frequency separating the signal and the noise was determined to make recommendations for low-pass digital filters, The global (noncoordinate specific) cutoff frequency was 6 Hz. The directional cutoff frequencies were 5.1, 3.9, and 5.6 Hz, in the anterior-posterior, superior-inferior and medial-lateral directions, respectively. Recommendations for the corner frequencies of low-pass Butterworth digital filters based on the cutoff frequency are higher than the corner frequencies used in previous studies of manual wheelchair propulsion kinematic data, This study provides a foundation for the data reduction of manual wheelchair propulsion kinematic data that is independent of gait literature. C1 Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15261 USA. VA Pittsburgh Hlth Care Syst, Human Engn Res Lab, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Med Ctr, Div PM&R, Pittsburgh, PA 15261 USA. RP DiGiovine, CP (reprint author), Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15261 USA. RI DiGiovine, Carmen/E-2982-2011 OI Boninger, Michael/0000-0001-6966-919X NR 33 TC 6 Z9 6 U1 1 U2 2 PU IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC PI NEW YORK PA 345 E 47TH ST, NEW YORK, NY 10017-2394 USA SN 1063-6528 J9 IEEE T REHABIL ENG JI IEEE Trans. Rehabil. Eng. PD SEP PY 2000 VL 8 IS 3 BP 385 EP 393 DI 10.1109/86.867880 PG 9 WC Engineering, Biomedical; Rehabilitation SC Engineering; Rehabilitation GA 354NN UT WOS:000089336700013 PM 11001518 ER PT J AU Pahlavani, MA Vargas, DM AF Pahlavani, MA Vargas, DM TI The effect of a ceramide analog, N-acetylsphingosine on the induction of proliferation and IL-2 synthesis in T cells from young and old F344 rats SO IMMUNOPHARMACOLOGY LA English DT Article DE ceramide; T cell activation; IL-2; apoptosis; rat; aging ID SIGNAL-TRANSDUCTION; CELLULAR SENESCENCE; INDUCED APOPTOSIS; OXIDATIVE STRESS; PHOSPHOLIPASE-D; AGE; ACTIVATION; EXPRESSION; SPHINGOMYELINASES; MICE AB Ceramide is a physiological mediator of extracellular signals that control various cellular functions, including proliferation and apoptosis. In the present study, we examined the effects of cell-permeable ceramide analog, N-acetyl-sphingosine (C-2-ceramide) on the induction of proliferation and interleukin-2 (IL-2) synthesis in T cells from young and old rats. Splenic T cells from 6- and 24-month-old Fischer 344 rats were treated with C-2-ceramide and then incubated with anti-CD3 antibody for 24 or 48 h. The induction of proliferation and IL-2 production by anti-CD3 was significantly (P < 0.001) lower in T cells from old rats compared to T cells from young rats. C-2-ceramide treatment resulted in suppression of proliferation and IL-2 production in a concentration-dependent manner. The suppressive effect of C-2-ceramide on proliferation and IL-2 production was greater in T cells from old rats than T cells from young rats, We investigated whether this decreased responsiveness was due to induction of program cell death (apoptosis) and found that there was a significant increase in DNA fragmentation in C-2-ceramide treated and anti-CD3 stimulated T cells from both young and old rats. The increase in DNA fragmentation was paralleled with an increase in caspase-3 activation, C-2-ceramide-induced caspase-3 activation and DNA fragmentation was significantly (P < 0.5) higher in stimulated T cells from old rats compared to stimulated T cells from young rats. These results suggest that the sphingomyelin-ceramide signaling pathway may play an important regulatory role in the well-documented age-related decline in immune function, (C) 2000 Elsevier Science B.V. All rights reserved. C1 Audie L Murphy Mem Vet Hosp, Geriatr Res Educ & Clin Ctr 182, S Texas Vet Hlth Care Syst, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. RP Pahlavani, MA (reprint author), Audie L Murphy Mem Vet Hosp, Geriatr Res Educ & Clin Ctr 182, S Texas Vet Hlth Care Syst, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. FU NIA NIH HHS [AG14088, AG00677] NR 49 TC 3 Z9 3 U1 1 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0162-3109 J9 IMMUNOPHARMACOLOGY JI Immunopharmacology PD SEP PY 2000 VL 49 IS 3 BP 345 EP 354 DI 10.1016/S0162-3109(00)00254-X PG 10 WC Immunology; Pharmacology & Pharmacy SC Immunology; Pharmacology & Pharmacy GA 358QK UT WOS:000089568600013 PM 10996032 ER PT J AU Rorty, M Yager, L Buckwalter, JG Rossotto, E Guthrie, D AF Rorty, M Yager, L Buckwalter, JG Rossotto, E Guthrie, D TI Development and validation of the parental intrusiveness rating scale among bulimic and comparison women SO INTERNATIONAL JOURNAL OF EATING DISORDERS LA English DT Article; Proceedings Paper CT 150th Annual Meeting of the American-Psychiatric-Association CY MAY 17-23, 1997 CL SAN DIEGO, CALIFORNIA SP Amer Psychiat Assoc DE parental intrusiveness; Parental Intrusiveness Rating Scale; disturbed relationships ID NERVOSA; ABUSE AB Objective: Based on hypotheses generated dr,ring clinical interviews with 80 women with a lifetime history of bulimia nervosa (BN), we designed an instrument for assessing the extent to which, women with BN report parental intrusiveness and breakdown of appropriate role boundaries during their adolescent development. Method: Through an iterative process of item generation and scale administration, the Parental Intrusiveness Rating Scale (PIRS), consisting of 20 maternal items and 20 paternal items, was developed. Maternal subscales include Invasion of Privacy, Jealousy and Competition, and Overconcern with the Daughter's Eating, Weight, and Shape. Paternal subscales include Invasion of Privacy Seductiveness, and Overconcern with the Daughter's Eating, Weight, and Shape. We validated the instrument using a subset of die above BN and comparison women (ns = 55 and 33, respectively), as well as an independent sample of women with BN and college com parison subjects (ns = 31 and 540, respectively). Results: Parental intrusiveness scores were significantly positively correlated with disturbed relationships in the family of origin of our initial cohort. Reliability analyses, both test-retest and item-scale correlations, revealed adequate to strong statistical associations in the combined sample. Conclusion: The PIRS promises to enrich our understanding of problematic parental behaviors among women who develop BN and allows us to broaden the conceptualization of familial risk factors for this disorder. (C) 2000 by John Wiley &Sons, Inc. C1 Univ New Mexico, Sch Med, Dept Psychiat, Albuquerque, NM 87131 USA. Univ So Calif, Sch Med, Dept Gerontol, Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Dept Psychiat, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Biostat, Los Angeles, CA USA. RP Yager, L (reprint author), Univ New Mexico, Sch Med, Dept Psychiat, 2400 Tucker NE, Albuquerque, NM 87131 USA. NR 23 TC 2 Z9 2 U1 1 U2 2 PU JOHN WILEY & SONS INC PI NEW YORK PA 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0276-3478 J9 INT J EAT DISORDER JI Int. J. Eating Disord. PD SEP PY 2000 VL 28 IS 2 BP 188 EP 201 DI 10.1002/1098-108X(200009)28:2<188::AID-EAT8>3.0.CO;2-X PG 14 WC Psychology, Clinical; Nutrition & Dietetics; Psychiatry; Psychology SC Psychology; Nutrition & Dietetics; Psychiatry GA 335JP UT WOS:000088240600008 PM 10897081 ER PT J AU Rorty, M Yager, J Rossotto, E Buckwalter, G AF Rorty, M Yager, J Rossotto, E Buckwalter, G TI Parental intrusiveness in adolescence recalled by women with a history of bulimia nervosa and comparison women SO INTERNATIONAL JOURNAL OF EATING DISORDERS LA English DT Article; Proceedings Paper CT 150th Annual Meeting of the American-Psychiatric-Association CY MAY 17-23, 1997 CL SAN DIEGO, CALIFORNIA SP Amer Psychiat Assoc DE intrusive parental behavior; Parental Intrusiveness Rating Scale; adolescence ID SEXUAL ABUSE; MOTHERS; GIRLS AB Objective: To learn if women with a lifetime history of bulimia nervosa (BN) report more intrusive parental behavior during adolescence than their nonclinical peers, and to provide further validation of the Parental Intrusiveness Rating Scale (PIRS). Method: We administered the PIRS to 86 women with a lifetime history of BN and 573 comparison subjects and examined between-group differences. Results: Relative to the comparison group, lifetime BN subjects reported higher levels of parental intrusiveness, specifically maternal invasion of privacy, maternal jealousy and competition, paternal seductiveness, and maternal and paternal overconcern with the daughter's eating, weight, and shape. There were no between-group differences in paternal invasion of privacy. In exploratory analyses with the comparison sample, Caucasian women reported greater maternal jealousy and competition than Asian American/Pacific Islander women, but there were no other differences. Conclusion: These results support clinical observations of high levels of parental intrusiveness in the adolescent experiences of women who develop BN. Nonclinical women of diverse ethnic backgrounds report largely equivalent experiences. (C) 2000 by John Wiley & Sons, Inc. C1 Univ New Mexico, Sch Med, Dept Psychiat, Albuquerque, NM 87131 USA. W Los Angeles Vet Adm Med Ctr, Dept Psychiat, Los Angeles, CA USA. Univ So Calif, Sch Med, Dept Gerontol, Los Angeles, CA USA. RP Yager, J (reprint author), Univ New Mexico, Sch Med, Dept Psychiat, 2400 Tucker NE, Albuquerque, NM 87131 USA. NR 25 TC 26 Z9 27 U1 0 U2 5 PU JOHN WILEY & SONS INC PI NEW YORK PA 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0276-3478 J9 INT J EAT DISORDER JI Int. J. Eating Disord. PD SEP PY 2000 VL 28 IS 2 BP 202 EP 208 DI 10.1002/1098-108X(200009)28:2<202::AID-EAT9>3.0.CO;2-G PG 7 WC Psychology, Clinical; Nutrition & Dietetics; Psychiatry; Psychology SC Psychology; Nutrition & Dietetics; Psychiatry GA 335JP UT WOS:000088240600009 PM 10897082 ER PT J AU Leybovich, LB Dogan, N Sethi, A AF Leybovich, LB Dogan, N Sethi, A TI A modified technique for RF-LCF interstitial hyperthermia SO INTERNATIONAL JOURNAL OF HYPERTHERMIA LA English DT Article DE hyperthermia; radiofrequency; localized; interstitial; concomitant AB To provide uniform heating of a tumour, it is necessary to establish sufficient volumetric control of power deposition. The interstitial Radio-Frequency Localized Current Field (RF-LCF) technique may provide such control when segmented electrodes are used. The length of segments is equal to 1-1.5 cm. Each segment is connected to a separate power source. However, this technique requires an additional implant for interstitial radiotherapy, because the lumen of segmented electrodes is filled with wires necessary to connect each segment to a separate power source. In this work, a modified method of implant that allows delivery of sequential and concomitant controlled thermoradiotherapy was investigated. In this method, each segmented electrode is surrounded by four continuous electrodes. Continuous electrodes pass through vertices of 1.5 x 1.5 cm square and a segmented electrode passes through the centre of the square. The distance between segmented and continuous electrodes is 1.06 cm. The electric field induced between an electrically interacting segment and continuous electrodes is concentrated primarily between this segment and its projection on continuous electrodes. Therefore, control of temperature distribution achieved with a modified implant is similar to that achieved with an implant containing only segmented electrodes. For temperature control during treatment, plastic catheters are inserted at a 0.5 cm distance from each segmented electrode. Temperature is monitored using multisensor temperature probes. The continuous electrodes are also used for placement of radioactive sources. The lateral distance between radioactive sources is equal to 1.5 cm. Besides allowing a sequential and concomitant thermoradiotherapy, the modified method is simpler to implement because it uses several fold less amount of segmented electrodes and power sources. C1 Loyola Univ, Stritch Sch Med, Dept Radiat Oncol, Div Med Phys, Maywood, IL 60153 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 61103 USA. RP Leybovich, LB (reprint author), Loyola Univ, Stritch Sch Med, Dept Radiat Oncol, Div Med Phys, 2160 S 1st Ave, Maywood, IL 60153 USA. NR 14 TC 2 Z9 3 U1 0 U2 0 PU TAYLOR & FRANCIS LTD PI LONDON PA 11 NEW FETTER LANE, LONDON EC4P 4EE, ENGLAND SN 0265-6736 J9 INT J HYPERTHER JI Int. J. Hyperthermia PD SEP PY 2000 VL 16 IS 5 BP 405 EP 413 PG 9 WC Oncology; Radiology, Nuclear Medicine & Medical Imaging SC Oncology; Radiology, Nuclear Medicine & Medical Imaging GA 352PC UT WOS:000089226200002 PM 11001574 ER PT J AU Stein, MD Cunningham, WE Nakazono, T Asch, S Turner, BJ Crystal, S Andersen, RM Zierler, S Bozzette, SA Shapiro, TF AF Stein, MD Cunningham, WE Nakazono, T Asch, S Turner, BJ Crystal, S Andersen, RM Zierler, S Bozzette, SA Shapiro, TF CA HIV Cost Serv Utilization Study Co TI Care of vaginal symptoms among HIV-infected women SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE vaginal symptoms; gynecologic manifestations; vaginitis; sexually transmitted diseases ID IMMUNODEFICIENCY-VIRUS INFECTION; NATIONAL PROBABILITY SAMPLES; LOW-PREVALENCE DISEASES; NORTH-AMERICAN WOMEN; BACTERIAL VAGINOSIS; SERVICES UTILIZATION; UNITED-STATES; ASSOCIATION; HEALTH; FLORA AB Objective: Gynecologic disease is common in HIV-infected women. We examine the sociodemographic, clinical, and provider factors associated with the care of women with vaginal symptoms. Methods: Women enrolled in the HIV Cost and Services Utilization Study (HCSUS), a nationally representative probability sample of HIV-infected adults, were interviewed between January 1996 and April 1997. Women with vaginal symptoms who sought medical attention were asked, "Did your health care provider examine your vaginal area?" Women were also asked if they received medication for their symptoms. Results: Among 154 women with vaginal symptoms, 127 sought care for their symptoms. Of those who sought care, 48% saw a gynecologist and 52% sought care from nongynecologists, most often their usual HIV care provider. Women who saw a gynecologist for their symptoms were more likely to have received a pelvic examination (92% versus 76%; p = .06) and vaginal fluid collection (98% versus 88%; p = .06) than those who saw their regular HIV provider. Fifteen percent of women received medication for their symptoms without having a pelvic examination; gynecologists were less likely to prescribe without an examination (8% versus 21%; p = .12). Conclusion: Gynecologists are more likely to provide adequate care of vaginal symptoms among HIV-infected women than nongynecologists who were HIV care providers. This specialty difference is consistent with quality of care studies for other medical conditions, but the potential gynecologic complications of inadequate evaluation and treatment warrants further investigation. C1 Brown Univ, Div Gen Med, Providence, RI 02912 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Div Gen Med & Hlth Serv Res, Los Angeles, CA USA. W Los Angles Vet Affairs Hosp, Los Angeles, CA USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Rutgers State Univ, Inst Hlth, AIDS Res Grp, New Brunswick, NJ 08903 USA. Brown Univ, Sch Med, Dept Community Hlth, Providence, RI 02912 USA. RAND Corp, Hlth Sci Program, Santa Monica, CA USA. Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA. Univ Calif Los Angeles, Div Gen Internal Med, Los Angeles, CA USA. RP Stein, MD (reprint author), Rhode Isl Hosp, Div Gen Internal Med, 593 Eddy St, Providence, RI 02903 USA. NR 27 TC 3 Z9 3 U1 2 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1525-4135 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD SEP 1 PY 2000 VL 25 IS 1 BP 51 EP 55 DI 10.1097/00126334-200009010-00007 PG 5 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 373FB UT WOS:000165276800007 PM 11064504 ER PT J AU Conhaim, RL Rodenkirch, LA Watson, KE Harms, BA AF Conhaim, RL Rodenkirch, LA Watson, KE Harms, BA TI Acellular hemoglobin solution enters compressed lung capillaries more readily than red blood cells SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE DCLHb; blood substitutes; plasma volume expanders; pulmonary microcirculation; pulmonary perfusion; zone I lung ID PULMONARY VASCULAR PERFUSION; LIGHT-MICROSCOPY; ELECTRON; ZONE-1 AB High lung inflation pressures compress alveolar septal capillaries, impede red cell transit, and interfere with oxygenation. However, recently introduced acellular hemoglobin solutions may enter compressed lung capillaries more easily than red blood cells. To test this hypothesis, we perfused isolated rat lungs with fluorescently labeled diaspirin cross-linked hemoglobin (DCLHb; 10%) and or autologous red cells (hematocrit, 20). Septal capillaries were compressed by setting lung inflation pressure above vascular pressures (zone 1). Examination by confocal microscopy showed that DCLHb was distributed throughout alveolar septa. Furthermore, this distribution was not affected by adding red blood cells to the perfusate. We estimated the maximum acellular hemoglobin mass within septa to be equivalent to that of 15 red blood cells. By comparison, we found an average of 2.7 +/- 4.6 red cells per septum in zone 1. These values increased to 30.4 +/- 25.8 and 50.4 +/- 22.1 cells per septum in zones 2 and 3, respectively. We conclude that perfusion in zone 1 with a 10% acellular hemoglobin solution may increase the hemoglobin concentration per septum up to fivefold compared with red cell perfusion. C1 William S Middleton Mem Vet Hosp, Dept Surg, Madison, WI 53705 USA. Univ Wisconsin, Dept Surg, Madison, WI 53705 USA. RP Conhaim, RL (reprint author), William S Middleton Mem Vet Hosp, Dept Surg, 2500 Overlook Terrace, Madison, WI 53705 USA. FU NHLBI NIH HHS [HL49985] NR 20 TC 7 Z9 7 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD SEP PY 2000 VL 89 IS 3 BP 1198 EP 1204 PG 7 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 352DX UT WOS:000089200200044 PM 10956369 ER PT J AU Ghosh-Choudhury, N Ghosh-Choudhury, G Woodruff, K Bsoul, S Nishimura, R Qi, W Celeste, A Abboud, S AF Ghosh-Choudhury, N Ghosh-Choudhury, G Woodruff, K Bsoul, S Nishimura, R Qi, W Celeste, A Abboud, S TI Identification of a Smad binding element (SBE) in BMP-3 responsive CSF-1 gene promoter: A mechanism of BMP-2-mediated transregulation of osteoclastogenesis during bone remodeling. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, GRECC, San Antonio, TX USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Osaka Univ, Suita, Osaka, Japan. Genet Inst, Boston, MA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2000 VL 15 SU 1 MA F027 BP S203 EP S203 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 346YJ UT WOS:000088898400263 ER PT J AU Peters, JH Carsons, S McDougall, S Yoshida, M Ko, F Hahn, TJ AF Peters, JH Carsons, S McDougall, S Yoshida, M Ko, F Hahn, TJ TI Characterization of N-terminal sequence-containing species of fibronectin in synovial fluid in osteoarthritis and rheumatoid arthritis. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract C1 Sacramento VA Med Ctr, Mather, CA USA. Winthrop Univ Hosp, Mineola, NY 11501 USA. W Los Angeles VA Healthcare Ctr, GRECC, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2000 VL 15 SU 1 MA SU059 BP S345 EP S345 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 346YJ UT WOS:000088898400832 ER PT J AU Vallarta-Ast, N Krueger, D Binkley, N AF Vallarta-Ast, N Krueger, D Binkley, N TI Bone mass measurement of the proximal femur and ultadistal radius best identifies osteoporosis in male veterans. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract C1 William S Middleton Mem Vet Adm Med Ctr, Dept Radiol, Madison, WI 53705 USA. Univ Wisconsin, Inst Aging, Madison, WI USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2000 VL 15 SU 1 MA SA347 BP S299 EP S299 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 346YJ UT WOS:000088898400644 ER PT J AU Yamaguchi, DT Makhijani, N Tomin, E McDougall, S Lane, JM Hahn, TJ AF Yamaguchi, DT Makhijani, N Tomin, E McDougall, S Lane, JM Hahn, TJ TI Immunohistochemical localization of angiogenic growth factors and chemokines in fracture repair. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract C1 VA Greater Los Angeles Healthcare System, GRECC, Los Angeles, CA USA. VA Greater Los Angeles Healthcare System, Res Serv, Los Angeles, CA USA. Hosp Special Surg, New York, NY 10021 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2000 VL 15 SU 1 MA SU140 BP S365 EP S365 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 346YJ UT WOS:000088898400913 ER PT J AU Ingelmo, C Frame, LH AF Ingelmo, C Frame, LH TI Mechanism for site-dependent differences in the shape of the resetting response curve in fixed barrier reentry SO JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY LA English DT Article DE resetting response curves; reentry; site dependence; excitable gap; tachycardia; interval-dependent conduction; resetting ID VENTRICULAR-TACHYCARDIA; TRANSIENT ENTRAINMENT; TRICUSPID RING; EXCITABLE GAP; TERMINATION; CIRCUIT; INVITRO; MODEL AB Site Dependence of Resetting Response Curves. Introduction: We investigated whether the site of stimulation within a reentrant circuit affects the resetting response curve (RRC), RRCs are used to characterize the excitable gap of reentrant circuits, including the duration of the fully excitable gap and the presence of partially excitable tissue. Methods and Results: We reset proximal and distal to a site of interval-dependent conduction (IDC) in canine in vitro atrial tricuspid rings. Adjustable reentry allowed changes in the cycle length and direction of reentry, In nine preparations we reset 26 tachycardias, In the 16 tachycardias with one site of IDC, RRCs were significantly different when stimulating distal and proximal to a site of interval-dependent conduction. For the distal, curves, the duration of the eat portion was 42 +/- 26 msec greater (P < 0.001), the slope of the increasing portion was 0.20 +/- 0.17 less (P < 0.02), and the increase in the return cycle was 14 +/- 9 msec less (P < 0.001). These differences resulted from early activation of the site of IDC by the antidromic premature impulse when stimulating from distal sites. As a result, the coupling interval of the orthodromic impulse at the site of IDC was the same or greater than at the stimulation site. In 10 tachycardias with multiple sites of IDC, significant differences in the resetting responses did not occur even when the antidromic impulse penetrated one site of IDC. Conclusion: In a fixed anatomic barrier reentrant circuit with one site of IDC, resetting distal to this site misrepresents the properties of the excitable gap of the entire circuit. C1 Vet Affairs Med Ctr, Cardiol Sect, Philadelphia, PA 19104 USA. Univ Penn, Div Cardiovasc, Philadelphia, PA 19104 USA. RP Frame, LH (reprint author), Vet Affairs Med Ctr, Cardiol Sect, Univ & Woodland Ave, Philadelphia, PA 19104 USA. FU NHLBI NIH HHS [HL38386] NR 15 TC 5 Z9 5 U1 0 U2 0 PU FUTURA PUBL CO PI ARMONK PA 135 BEDFORD RD, PO BOX 418, ARMONK, NY 10504-0418 USA SN 1045-3873 J9 J CARDIOVASC ELECTR JI J. Cardiovasc. Electrophysiol. PD SEP PY 2000 VL 11 IS 9 BP 981 EP 989 DI 10.1111/j.1540-8167.2000.tb00170.x PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 356QH UT WOS:000089453600005 PM 11021468 ER PT J AU Iwen, PC Tarantolo, SR Sutton, DA Rinaldi, MG Hinrichs, SH AF Iwen, PC Tarantolo, SR Sutton, DA Rinaldi, MG Hinrichs, SH TI Cutaneous infection caused by Cylindrocarpon lichenicola in a patient with acute myelogenous leukemia SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID FUSARIUM AB Cylindrocarpon lichenicola is a saprophytic soil fungus which has rarely been associated with human disease. We report the first case of localized invasive cutaneous infection caused by this fungus in a 53-year-old male from the rural midwestern United States with relapsed acute myelogenous leukemia. On admission for induction chemotherapy, the patient was noted to have an abrasive laceration between the fourth and fifth metacarpophalangeal joints and on the dorsum of the right hand, which progressed to frank ulceration following chemotherapy. A biopsy provided an initial diagnosis of an invasive fungal infection consistent with aspergillosis based on the histopathological appearance of the mold in tissue. Multiple positive fungal cultures which were obtained from the biopsied tissue were subsequently identified by microscopic and macroscopic characteristics to be C. lichenicola. The infection resolved following marrow regeneration, aggressive debridement of the affected tissue, and treatment with amphotericin B. This case extends the conditions associated with invasive disease caused by C. lichenicola. C1 Univ Nebraska, Med Ctr, Dept Pathol & Microbiol, Omaha, NE 68198 USA. Univ Nebraska, Med Ctr, Dept Internal Med, Omaha, NE USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, Fungus Testing Lab, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. RP Iwen, PC (reprint author), Univ Nebraska, Med Ctr, Dept Pathol & Microbiol, 986495 Nebraska Med Ctr, Omaha, NE 68198 USA. NR 20 TC 10 Z9 10 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD SEP PY 2000 VL 38 IS 9 BP 3375 EP 3378 PG 4 WC Microbiology SC Microbiology GA 350RG UT WOS:000089114500040 PM 10970386 ER PT J AU Stewart, L Ponce, R Oesterle, AL Griffiss, JM Way, LW AF Stewart, L Ponce, R Oesterle, AL Griffiss, JM Way, LW TI Pigment gallstone pathogenesis: Slime production by biliary bacteria is more important than beta-glucuronidase production SO JOURNAL OF GASTROINTESTINAL SURGERY LA English DT Article; Proceedings Paper CT 40th Annual Meeting of the Society-for-Surgery-of-the-Alimentary-Tract CY MAY 16-19, 1999 CL ORLANDO, FLORIDA SP Soc Surg Alimentary Tract DE gallstones; bacterial slime; glycocalyx; beta-glucuronidase ID COMMON BILE-DUCT; UNCONJUGATED BILIRUBIN; BLOCKAGE; BIOFILM; ENDOPROSTHESES; CHOLELITHIASIS; DISEASE; STENTS; MODEL; PH AB Pigment stones are thought to form as a result of deconjugation of bilirubin by bacterial beta -glucuronidase, which results in precipitation of calcium bilirubinate. Calcium bilirubinate is then aggregated into stones by an anionic glycoprotein. Slime (glycocalyx), an anionic glycoprotein produced by bacteria causing foreign body infections, has been implicated in the formulation of the precipitate that blocks biliary stents. We previously showed that bacteria are present within the pigment portions of gallstones and postulated a bacterial role in pigment stone formation through beta -glucuronidase or slime production. Ninety -one biliary bacterial isolates from 61 patients and 12 control stool organisms were tested for their production of beta -glucuronidase and slime. The average slime production was 42 for biliary bacteria and 2.5 for stool bacteria (P < 0.001). Overall, 73% of biliary bacteria and 8% of stool bacteria produced slime (optical density >3). In contrast, only 38% of biliary bacteria produced beta -glucuronidase. Eighty-two percent of all patients, 90% of patients with common bile duct (CBD) stones, 100% of patients with primary CBD stones, and 93% of patients with biliary tubes had one or more bacterial species in their stones that produced slime. By comparison, only 47% of all patients, 60% of patients with CBD stones, 62 of patients with primary CBD stones, and 50% of patients with biliary T tubes had one or more bacteria that produced beta- glucuronidase. Most biliary bacteria produced slime, and slime production correlated better than beta -glucuronidase production did with stone formation and the presence of biliary tubes or stents. Patients with primary CBD stones and biliary tubes had the highest incidence of slime production. These findings suggest that bacterial slime is important in gallstone formation and the blockage of biliary tubes. C1 Univ Calif San Francisco, Vet Adm Med Ctr, Dept Surg, Surg Serv 112, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Microbiol, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Stewart, L (reprint author), Univ Calif San Francisco, Vet Adm Med Ctr, Dept Surg, Surg Serv 112, 4150 Clement St, San Francisco, CA 94121 USA. NR 28 TC 22 Z9 26 U1 0 U2 1 PU QUALITY MEDICAL PUBLISHING INC PI ST LOUIS PA 11970 BORMAN DR, STE 222, ST LOUIS, MO 63146 USA SN 1091-255X J9 J GASTROINTEST SURG JI J. Gastrointest. Surg. PD SEP-OCT PY 2000 VL 4 IS 5 BP 547 EP 553 DI 10.1016/S1091-255X(00)80100-6 PG 7 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 418XJ UT WOS:000167919400017 PM 11077333 ER PT J AU Mahoney, JE Eisner, J Havighurst, T Gray, S Palta, M AF Mahoney, JE Eisner, J Havighurst, T Gray, S Palta, M TI Problems of older adults living alone after hospitalization SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE hospitalization; risk factors; activities of daily living; socioeconomic factors; support; aged ID ACUTE MEDICAL ILLNESS; NURSING-HOME; FUNCTIONAL STATUS; SOCIAL SUPPORT; RISK-FACTORS; CARE; DEPRESSION; DECLINE; INSTITUTIONALIZATION; ADMISSION AB OBJECTIVE: To describe functional deficits among older adults living alone and receiving home nursing following medical hospitalization, and the association of living alone with lack of functional improvement and nursing home utilization 1 month after hospitalization. DESIGN: Secondary analysis of a prospective cohort study. PARTICIPANTS: Consecutive sample of patients age 65 and over receiving home nursing following medical hospitalization, Patients were excluded for new diagnosis of myocardial infarction or stroke in the previous 2 months, diagnosis of dementia if living alone, or nonambulatory status. Of 613 patients invited to participate, 312 agreed. MEASUREMENTS: One week after hospitalization, patients were assessed in the home for demographic information, medications, cognition, and self-report of prehospital and current mobility and function in activities of daily living (ADLs) and independent activities of daily living (IADLs). One month later, patients were asked about current function and nursing home utilization. The outcomes were lack of improvement in ADL function and nursing home utilization 1 month after hospitalization. RESULTS: One hundred forty-one (45%) patients lived alone. After hospital discharge, 40% of those living alone and 62% of those living with others had at least 1 ADL dependency (P = .0001). Patients who were ADL dependent and lived alone were 3.3 (95% confidence interval [95% CI], 1.4 to 7.6) times less likely to improve in ADLs and 3.5 (95% CI, 1.0 to 11.9) times more likely to be admitted to a nursing home in the month after hospitalization. CONCLUSION: Patients who live alone and receive home nursing after hospitalization are less likely to improve in function and more likely to be admitted to a nursing home, compared with those who live with others. More intensive resources may be required to continue community living and maximize independence. C1 William S Middleton Mem Vet Hosp, GRECC Serv, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Dept Med, Madison, WI USA. Univ Wisconsin, Inst Aging, Madison, WI USA. Univ Wisconsin, Dept Biostat & Med Informat, Madison, WI USA. Univ Washington, Sch Pharm, Seattle, WA 98195 USA. Univ Wisconsin, Sch Med, Dept Prevent Med, Madison, WI USA. RP Mahoney, JE (reprint author), William S Middleton Mem Vet Hosp, GRECC Serv, 2500 Overlook Terrace, Madison, WI 53705 USA. FU NIA NIH HHS [K08AG00623] NR 38 TC 28 Z9 30 U1 2 U2 4 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD SEP PY 2000 VL 15 IS 9 BP 611 EP 619 DI 10.1046/j.1525-1497.2000.06139.x PG 9 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 362QZ UT WOS:000089790900001 PM 11029674 ER PT J AU Rosenfeld, KE Wenger, NS Kagawa-Singer, M AF Rosenfeld, KE Wenger, NS Kagawa-Singer, M TI End-of-life decision making - A qualitative study of elderly individuals SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE advance care planning; aged; decision making; life-sustaining treatment; physician-patient relations; proxy; terminal care ID CARDIOPULMONARY-RESUSCITATION; INTENSIVE-CARE; BREAST-CANCER; ILL PATIENTS; PREFERENCES; SURVIVAL; AGE; CHOICES; OLDER; DEATH AB OBJECTIVE: To identify the desired features of end-of-life medical decision making from the perspective of elderly individuals. DESIGN: Qualitative study using in-depth interviews and analysis from a phenomenologic perspective. SETTING: A senior center and a multilevel retirement community in Los Angeles. PARTICIPANTS: Twenty-one elderly informants (mean age 83 years) representing a spectrum of functional status and prior experiences with end-of-life decision making. MAIN RESULTS: Informants were concerned primarily with the outcomes of serious illness rather than the medical interventions that might be used, and defined treatments as desirable to the extent they could return the patient to his or her valued life activities. Advanced age was a relevant consideration in decision making, guided by concerns about personal losses and the meaning of having lived a "full life." Decisionmaking authority was granted both to physicians (for their technical expertise) and family members (for their concern for the patient's interests), and shifted from physician to family as the patient's prognosis for functional recovery became grim. Expressions of care, both by patients and family members, were often important contributors to end-of-life treatment decisions. CONCLUSIONS: These findings suggest that advance directives and physician-patient discussions that focus on acceptable health states and valued life activities may be better suited to patients' end-of-Life care goals than those that focus on specific medical interventions, such as cardiopulmonary resuscitation. We propose a model of collaborative surrogate decision making by families and physicians that encourages physicians to assume responsibility for recommending treatment plans, including the provision or withholding of specific life-sustaining treatments, when such recommendations are consistent with patients' and families' goals for care. C1 Vet Adm Greater Los Angeles Healthcare Syst, Div Gen Internal Med 111G, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Publ Hlth & Asian Amer Studies, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. RP Rosenfeld, KE (reprint author), Vet Adm Greater Los Angeles Healthcare Syst, Div Gen Internal Med 111G, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 41 TC 108 Z9 108 U1 2 U2 14 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD SEP PY 2000 VL 15 IS 9 BP 620 EP 625 DI 10.1046/j.1525-1497.2000.06289.x PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 362QZ UT WOS:000089790900002 PM 11029675 ER PT J AU Covinsky, KE AF Covinsky, KE TI Bringing a generalist approach to the problems of older patients SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Editorial Material ID FUNCTIONAL OUTCOMES; ILL; GERIATRICS; SYMPTOMS; CARE C1 San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. RP Covinsky, KE (reprint author), San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. NR 16 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD SEP PY 2000 VL 15 IS 9 BP 673 EP 674 DI 10.1046/j.1525-1497.2000.00719.x PG 2 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 362QZ UT WOS:000089790900010 PM 11029683 ER PT J AU Conigliaro, J Kraemer, K McNeil, M AF Conigliaro, J Kraemer, K McNeil, M TI Screening and identification of older adults with alcohol problems in primary care SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article ID CAGE QUESTIONNAIRE; USE DISORDERS; ELDERLY VETERANS; UNITED-STATES; SELF-REPORTS; TEST AUDIT; ABUSE; CONSUMPTION; DRINKING; DRINKERS AB Primary care physicians can anticipate encountering more elderly patients with alcohol problems since this population is increasing and the prevalence of alcohol problems has been stable. Brief screening tools, originally developed and validated among younger adults, may not be appropriate in the elderly. Therefore, specific validation studies and the development of elderly specific instruments have been reported. The specific goals of this report are to (1) review available screening tools for alcohol problems, (2) summarize elderly focused studies, and (3) provide recommendations for use in primary care. Using a variety of standards, the CAGE (Cut down, Annoyed, Guilty, and Eye opener) is the most consistent brief screen, but its threshold may need to be adjusted in the elderly. The Michigan Alcoholism Screening Test-Geriatric Version includes elderly-specific consequences, but its length may hinder routine use even in shortened form. Finally, the Alcohol Use Disorders Identification Test, although less sensitive than the CAGE, can also capture problem drinkers. Efforts are needed to include elderly-specific consequences and meaningful consumption thresholds in a brief, easily applied screen. C1 VA Pittsburgh Hlth Care Syst, Sect Gen Internal Med 11E120, Ctr Hlth Serv Res, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Div Gen Med, Ctr Res Hlth Care, Pittsburgh, PA USA. RP Conigliaro, J (reprint author), VA Pittsburgh Hlth Care Syst, Sect Gen Internal Med 11E120, Ctr Hlth Serv Res, 11A,Univ Dr C, Pittsburgh, PA 15240 USA. FU NIAAA NIH HHS [5K08-AA00235] NR 61 TC 35 Z9 37 U1 1 U2 4 PU DECKER PERIODICALS INC PI HAMILTON PA 4 HUGHSON STREET SOUTH PO BOX 620, LCD 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD FAL PY 2000 VL 13 IS 3 BP 106 EP 114 PG 9 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 353FU UT WOS:000089264800002 PM 11001132 ER PT J AU Schonfeld, L Dupree, LW Dickson-Fuhrmann, E Royer, CM McDermott, CH Rosansky, JS Taylor, S Jarvik, LF AF Schonfeld, L Dupree, LW Dickson-Fuhrmann, E Royer, CM McDermott, CH Rosansky, JS Taylor, S Jarvik, LF TI Cognitive-behavioral treatment of older veterans with substance abuse problems SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article AB The authors describe the initial cohort of participants in the GET SMART program, an age-specific, outpatient program for older veterans with substance abuse problems. Chief among the program's services is a relapse-prevention intervention consisting of 16 weekly group sessions using cognitive-behavioral (CB) and self-management approaches. Group sessions begin with analysis of substance use behavior to determine high-risk situations for alcohol or drug use, followed by a series of modules to teach coping skills for coping with social pressure, being at home and alone, feelings of depression and loneliness, anxiety and tension, anger and frustration, cues for substance use, urges (self-statements), and slips or relapses. Of the first 110 admissions, more than one-third were homeless, which is indicative of the severity of psychosocial distress of the patients, and more than one-third used illicit drugs. A total of 49 patients completed CB treatment groups and 61 dropped out of treatment. At 6-month follow-up, program completers demonstrated much higher rates of abstinence compared to noncompleters. The results suggest that CB approaches work well with older veterans with significant medical, social, and drug use problems. C1 Univ S Florida, Louis De La Porte Florida Mental Hlth Inst, Dept Aging & Mental Hlth, Tampa, FL 33612 USA. VA Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, GET SMART Team, Los Angeles, CA USA. RP Schonfeld, L (reprint author), Univ S Florida, Louis De La Porte Florida Mental Hlth Inst, Dept Aging & Mental Hlth, Tampa, FL 33612 USA. NR 15 TC 25 Z9 25 U1 2 U2 9 PU DECKER PERIODICALS INC PI HAMILTON PA 4 HUGHSON STREET SOUTH PO BOX 620, LCD 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD FAL PY 2000 VL 13 IS 3 BP 124 EP 129 PG 6 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 353FU UT WOS:000089264800004 PM 11001134 ER PT J AU Royer, CM Dickson-Fuhrmann, E McDermott, CH Taylor, S Rosansky, JS Jarvik, LF AF Royer, CM Dickson-Fuhrmann, E McDermott, CH Taylor, S Rosansky, JS Jarvik, LF TI Portraits of change: Case studies from an elder-specific addiction program SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article AB The authors describe two case histories of patients served by the GET SMART program that provide a glimpse of typical client substance abuse histories and their remarkable journeys of change. An age-specific outpatient program for older veterans with illicit drug and alcohol dependence, the GET SMART program uses individualized and group treatment interventions in an environment of collaboration, respect, and hope. The program employs the stages of change framework and a clinical framework that includes cognitive-behavioral and motivational interviewing approaches. C1 VA Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, GET SMART Program, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, UPBEAT Program, Los Angeles, CA 90073 USA. RP Royer, CM (reprint author), VA Greater Los Angeles Healthcare Syst, W Los Angeles Healthcare Ctr, GET SMART Program, Los Angeles, CA 90073 USA. NR 6 TC 1 Z9 1 U1 1 U2 1 PU DECKER PERIODICALS INC PI HAMILTON PA 4 HUGHSON STREET SOUTH PO BOX 620, LCD 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD FAL PY 2000 VL 13 IS 3 BP 130 EP 133 PG 4 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 353FU UT WOS:000089264800005 PM 11001135 ER PT J AU Bryant, AE Chen, RYZ Nagata, Y Wang, Y Lee, CH Finegold, S Guth, PH Stevens, DL AF Bryant, AE Chen, RYZ Nagata, Y Wang, Y Lee, CH Finegold, S Guth, PH Stevens, DL TI Clostridial gas gangrene. I. Cellular and molecular mechanisms of microvascular dysfunction induced by exotoxins of Clostridium perfringens SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 1st American-Society-for-Microbiology Conference on Microbes, Haemostasis, and Vascular Biology CY MAR, 1998 CL GALVESTON, TEXAS SP Amer Soc Microbiol ID PHOSPHOLIPASE-C; ALPHA-TOXIN; ACTIVATED PLATELETS; ENDOTHELIAL-CELLS; EXPRESSION; LEUKOCYTES; FLOW AB Mechanisms responsible for the rapid tissue destruction in gas gangrene are not well understood. To examine the early effects of Clostridium perfringens exotoxins on tissue perfusion, a rat model of muscle blood flow was developed. Intramuscular injection of a clostridial toxin preparation containing both phospholipase C (PLC) and theta-toxin caused a rapid (1-2 min) and irreversible decrease in blood how that paralleled formation of activated platelet aggregates in venules and arterioles. Later (20-40 min), aggregates contained fibrin and leukocytes, and neutrophils accumulated along vascular walls. Flow cytometry confirmed that these clostridial toxins or recombinant PLC induced formation of P-selectin-positive platelet aggregates. Neutralization of PLC activity in the clostridial toxin preparation completely abrogated human platelet responses and reduced perfusion deficits. It is concluded that tissue destruction in gas gangrene is related to profound attenuation of blood how initiated by activation of platelet responses by PLC. C1 Vet Affairs Med Ctr, Infect Dis Sect, Boise, ID 83702 USA. Univ Idaho, Dept Microbiol, Moscow, ID 83843 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Anesthesiol, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ Washington, Sch Med, Seattle, WA USA. RP Bryant, AE (reprint author), Vet Affairs Med Ctr, Infect Dis Sect, Bldg 45,500 W Ft St, Boise, ID 83702 USA. NR 28 TC 48 Z9 50 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD SEP PY 2000 VL 182 IS 3 BP 799 EP 807 DI 10.1086/315756 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 355LH UT WOS:000089386800020 PM 10950774 ER PT J AU Bryant, AE Chen, RYZ Nagata, Y Wang, Y Lee, CH Finegold, S Guth, PH Stevens, DL AF Bryant, AE Chen, RYZ Nagata, Y Wang, Y Lee, CH Finegold, S Guth, PH Stevens, DL TI Clostridial gas gangrene. II. Phospholipase C-induced activation of platelet gpIIbIIIa mediates vascular occlusion and myonecrosis in Clostridium perfringens gas gangrene SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 9th European Workshop on Bacterial Protein Toxins CY JUN, 1999 CL STE MAXIME, FRANCE ID HUMAN POLYMORPHONUCLEAR LEUKOCYTES; WHOLE-BLOOD; FIBRINOGEN; ADHESION; TOXIN; GLYCOPROTEIN; EXPRESSION; CD11B/CD18; SELECTIN; MAC-1 AB Clostridium perfringens gas gangrene is a fulminant infection, and radical amputation re mains the single best treatment. It has been hypothesized that rapid tissue destruction is related to tissue hypoxia secondary to toxin-induced vascular obstruction, and previous studies demonstrated that phospholipase C (PLC) caused a rapid and irreversible decrease in skeletal muscle blood flow that paralleled the formation of intravascular aggregates of activated plate lets, fibrin, and leukocytes, In this study, flow cytometry demonstrated that PLC stimulated platelet/neutrophil aggregation in a gpIIbIIIa-dependent fashion. Pretreatment of animals with heparin or depletion of leukocytes reduced blood-flow deficits, and aggregate formation caused by PLC. It is concluded that fulminant tissue destruction in gas gangrene results from profound attenuation of blood dow caused by PLC-induced, gpIIbIIIa-mediated formation of heterotypic platelet/polymorphonuclear leukocyte aggregates. Therapeutic strategies that target gpIIbIIIa may prevent vascular occlusion, maintain tissue viability, and provide an alternative to radical amputation for patients with this infection. C1 Vet Affairs Med Ctr, Infect Dis Sect, Boise, ID 83702 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Anesthesiol, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ Washington, Sch Med, Seattle, WA USA. RP Bryant, AE (reprint author), Vet Affairs Med Ctr, Infect Dis Sect, Bldg 45,500 W Ft St, Boise, ID 83702 USA. NR 28 TC 50 Z9 50 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD SEP PY 2000 VL 182 IS 3 BP 808 EP 815 DI 10.1086/315757 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 355LH UT WOS:000089386800021 PM 10950775 ER PT J AU Mendez, MF AF Mendez, MF TI Language-selective anemia in a bilingual patient SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Letter C1 Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Mendez, MF (reprint author), Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90095 USA. NR 5 TC 1 Z9 1 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD FAL PY 2000 VL 12 IS 4 BP 515 EP 516 DI 10.1176/appi.neuropsych.12.4.515 PG 2 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 369DR UT WOS:000165051200014 PM 11083172 ER PT J AU Bridgeford, D Arciniegas, DB Batkis, M Sandberg, E Beresford, TP AF Bridgeford, D Arciniegas, DB Batkis, M Sandberg, E Beresford, TP TI Methylphenidate treatment of neuropsychiatric symptoms of central and extrapontine myelinolysis SO JOURNAL OF STUDIES ON ALCOHOL LA English DT Article ID CENTRAL PONTINE MYELINOLYSIS; TRAUMATIC BRAIN INJURY; MANIFESTATIONS AB Objective: Previous reports describe the presentation and course of the neurobehavioral manifestations cf central and extrapontine myelinolysis; as of yet, however, there are no specific recommendations far treatment of these problems. We offer the first report of successful treatment. Method: We describe a 55-year-old man with chronic alcoholism who developed central and extrapontine myelinolysis following an episode of heavy drinking and rapid correction of hyponatremia The patient acutely developed motor, cognitive, emotional and behavioral problems best accounted for by central pontine and bilateral striatal myelinolysis. These neuropsychiatric symptoms were treated with methylphenidate over the course of I month in an off-on-off-on fashion. The Neuropsychiatric Inventory and other tests were used to assess treatment response. Results: Marked improvements in the patient's neuropsychiatric status were noted only during treatment with methylphenidate. Conclusions: Methylphenidate effectively reversed the neuropsychiatric symptoms associated with the patient's demyelinating lesions. We discuss possible underlying mechanisms of both symptom formation and treatment effect. C1 Denver Vet Affairs Med Ctr, Psychiat Serv 116, Denver, CO 80220 USA. RP Bridgeford, D (reprint author), Denver Vet Affairs Med Ctr, Mental Hlth Serv, 1055 Clermont St, Denver, CO 80220 USA. RI Arciniegas, David/A-3792-2009 NR 21 TC 5 Z9 6 U1 0 U2 0 PU ALCOHOL RES DOCUMENTATION INC CENT ALCOHOL STUD RUTGERS UNIV PI PISCATAWAY PA C/O DEIRDRE ENGLISH, 607 ALLISON RD, PISCATAWAY, NJ 08854-8001 USA SN 0096-882X J9 J STUD ALCOHOL JI J. Stud. Alcohol PD SEP PY 2000 VL 61 IS 5 BP 657 EP 660 PG 4 WC Substance Abuse; Psychology SC Substance Abuse; Psychology GA 358KU UT WOS:000089557900004 PM 11022803 ER PT J AU Ferrell, BA Josephson, K Norvid, P Alcorn, H AF Ferrell, BA Josephson, K Norvid, P Alcorn, H TI Pressure ulcers among patients admitted to home care SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE pressure sores; decubitus; home care ID LONG-TERM-CARE; BRADEN-SCALE; SORE RISK; PREVENTIVE INTERVENTIONS; PREDICTIVE-VALIDITY; MULTISITE; COST AB CONTEXT: Pressure ulcers are an understudied problem in home care. OBJECTIVE: To determine the prevalence of pressure ulcers among patients admitted to home care services, describe the demographic and health characteristics associated with pressure ulcers in this setting, and identify the percentage of these patients at risk for developing pressure ulcers. DESIGN: Cross-sectional survey of patients on admission to home care agencies. SETTING: Forty-one home care agencies in 14 states. PATIENTS: A consecutive sample of 3048 patients admitted March 1 through April 30, 1996 (86% of all admissions). Subjects had a mean age of 75 years; 63% were female and 85% white. MAIN OUTCOME MEASURES: Demographic, social, and clinical characteristics, functional status (Katz activities of daily living scale and Lawton instrumental activities of daily living scale), mental status (Katzman Short Memory-Orientation-Concentration test), pressure ulcer risk (Braden Scale), pressure ulcer status (Bates-Jensen Pressure Ulcer Status Tool), and a checklist of pressure-reducing devices and wound care products being used. RESULTS: In the total sample of 3048 patients, 9.12% had pressure injuries: 37.4% had more than one ulcer and 14.0% had three or more ulcers. Considering the worst ulcer for each subject, 40.3% had Stage II and 27% had Stage III or IV injuries. Characteristics associated with pressure ulcers included recent institutional discharge, functional impairment, incontinence, and having had a previous ulcer. About 30% of subjects were at risk for new pressure ulcers. Pressure-relieving devices and other wound care strategies appeared to be underutilized and often indiscriminately applied. CONCLUSIONS: There is substantial need for pressure ulcer prevention and treatment in home care settings. C1 Univ Calif Los Angeles, Sch Med, Div Geriatr, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Med, Multicampus Program Geriatr & Gerontol, Los Angeles, CA 90095 USA. LaGrange Mem Hosp, LaGrange, IL USA. Total Renal Res Inc, Minneapolis, MN USA. RP Ferrell, BA (reprint author), Univ Calif Los Angeles, Sch Med, Div Geriatr, 10945 Le Conte Ave, Los Angeles, CA 90095 USA. NR 24 TC 39 Z9 40 U1 3 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD SEP PY 2000 VL 48 IS 9 BP 1042 EP 1047 PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 351PR UT WOS:000089167800002 PM 10983902 ER PT J AU Clarke, P Meintzer, SM Gibson, S Widmann, C Garrington, TP Johnson, GL Tyler, KL AF Clarke, P Meintzer, SM Gibson, S Widmann, C Garrington, TP Johnson, GL Tyler, KL TI Reovirus-induced apoptosis is mediated by TRAIL SO JOURNAL OF VIROLOGY LA English DT Article ID INFLUENZA-VIRUS INFECTION; PROGRAMMED CELL-DEATH; NECROSIS-FACTOR-ALPHA; FAS; ACTIVATION; PATHWAY; MODULATION; EXPRESSION; INHIBITION; RECEPTORS AB Members of the tumor necrosis factor (TNF) receptor superfamily and their activating ligands transmit apoptotic signals in a variety of systems. We now show that the binding of TNF-related, apoptosis-inducing ligand (TRAIL) to its cellular receptors DR5 (TRAILR2) and DR4 (TRAILR1) mediates reovirus-induced apoptosis. Anti-TRAIL antibody and soluble TRAIL receptors block reovirus-induced apoptosis by preventing TRAIL-receptor binding. In addition, reovirus induces both TRAIL release and an increase in the expression of DR5 and DR4 in infected cells. Reovirus-induced apoptosis is also blocked following inhibition of the death receptor-associated, apoptosis-inducing molecules FADD (for LAS-associated death domain) and caspase 8. We propose that reovirus infection promotes apoptosis via the expression of DR5 and the release of TRAIL from infected cells. Virus-induced regulation of the TRAIL apoptotic pathway defines a novel mechanism for virus-induced apoptosis. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Pharmacol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med Microbiol & Immunol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO 80262 USA. Natl Jewish Ctr Immunol & Resp Med, Program Mol Signal Transduct, Denver, CO 80206 USA. Natl Jewish Ctr Immunol & Resp Med, Div Basic Sci, Denver, CO 80206 USA. RP Tyler, KL (reprint author), Denver VA Med Ctr, Dept Neurol 127, 1066 Clermont St, Denver, CO 80220 USA. RI Widmann, Christian/N-9851-2013 OI Widmann, Christian/0000-0002-6881-0363; Gibson, Spencer/0000-0003-0119-732X; Tyler, Kenneth/0000-0003-3294-5888 FU NIA NIH HHS [1RO1AG14071]; NIGMS NIH HHS [GM30324, R01 GM030324, R37 GM030324] NR 31 TC 146 Z9 155 U1 0 U2 4 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD SEP PY 2000 VL 74 IS 17 BP 8135 EP 8139 DI 10.1128/JVI.74.17.8135-8139.2000 PG 5 WC Virology SC Virology GA 346JD UT WOS:000088866500050 PM 10933724 ER PT J AU Royall, DR Chiodo, LK Polk, MJ AF Royall, DR Chiodo, LK Polk, MJ TI Correlates of disability among elderly retirees with "subclinical" cognitive impairment SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article; Proceedings Paper CT 52nd Annual Scientific Meeting of the Gerontological-Society-of-America CY NOV 19-23, 1999 CL SAN FRANCISCO, CALIFORNIA SP Gerontol Soc Amer ID MINI-MENTAL-STATE; ALZHEIMERS-DISEASE; GLUCOSE-UTILIZATION; UNAWARENESS; DYSFUNCTION; FEATURES; DEMENTIA; DEFICITS AB Background We assessed the effects of impaired Executive Control Function (ECF) on Instrumental Activities of Daily Living (IADL) and level of tare among noninstitutionalized elderly retirees with "subclinical" cognitive impairment. Methods. Subjects (N = 561; age 78.2 +/- 5.0 years) were residents of a single, 1500 bed, continuing care retirement community. Subjects were examined for cognitive impairment using the Executive Interview (EXIT25), Mini-Mental State Examination (MMSE), and an executive clock-drawing task (CLOX). The CLOX is divided into executively sensitive (CLOX1) and simple constructional (CLOX2) subtests. Results. Residents in congregate high-rises (n = 301) differed significantly From those in independent-living apartments (n = 260) with respect to age, gender, percent living alone, EXIT25, CLOX1, MMSE, and CLOX2 scores (all P < .03). Only differences in ECF measures persisted after adjusting for age and living alone (p < .004). The EXIT25 (P < .006) and CLOX2 (p = .02) were associated with the use of prostheses. The differences in EXIT25 scores persisted after adjusting for level and living alone (p = .01). All instruments distinguished residents with impairment in IADLs. However, only CLOX2 (p < .001), EXIT25 (p < .001), and age (p < .001) made significant independent contributions. Conclusions. ECF has statistically significant effects on level of care and IADL impairment, even among noninstitutionalized retirees. This emergent disability is not well detected by traditional global cognitive measures. Evaluation and treatment may he delayed unless ECF measures are employed. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA. S Texas Vet Hlth Syst, Audie L Murphy Div GRECC, Dept Psychiat, San Antonio, TX USA. S Texas Vet Hlth Syst, Audie L Murphy Div GRECC, Dept Med, San Antonio, TX USA. S Texas Vet Hlth Syst, Audie L Murphy Div GRECC, Dept Pharmacol, San Antonio, TX USA. RP Royall, DR (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. NR 48 TC 88 Z9 88 U1 3 U2 6 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD SEP PY 2000 VL 55 IS 9 BP M541 EP M546 PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 373WC UT WOS:000165312200017 PM 10995053 ER PT J AU Felsenfeld, AJ Jara, A Avedian, G Kleeman, CR AF Felsenfeld, AJ Jara, A Avedian, G Kleeman, CR TI Effects of fasting, feeding, and bisphosphonate administration on serum calcitriol levels in phosphate-deprived rats SO KIDNEY INTERNATIONAL LA English DT Article DE hypercalcemia; parathyroid hormone; dietary phosphate; metabolism ID PHOSPHORUS DEPRIVATION; DIETARY PHOSPHORUS; PARATHYROID-HORMONE; BONE-RESORPTION; GROWTH-HORMONE; 1,25-DIHYDROXYVITAMIN-D CONCENTRATIONS; D METABOLISM; IN-VITRO; CALCIUM; DEPLETION AB Background. In a recent study, we showed in phosphate deprived rats that morning feeding decreased serum phosphate and increased serum calcium values as compared with similar rats: fasted overnight, and high doses of bisphosphonates did not reduce the magnitude of hypercalcemia. In the present study, we evaluated in phosphate-deprived rats whether serum calcitriol values were: (I) affected by the differences in serum phosphate induced by morning feeding and overnight fasting, (2) correlated with changes in serum phosphate levels, and (3) influenced by bisphosphonate administration. Methods. Four groups of rats were studied: (I) low-phosphate diet (LPD; P < 0.05%), (2) LPD + the bisphosphonate pamidronate (APD): (3) normal diet (ND: P 0.6%), and (4) ND + APD, Both diets contained 0.6% calcium. In rats receiving APD, high doses (0.8 mg/kg) were given subcutaneously four times during the study. On day 11, rats were sacrificed after an overnight fast or two to four hours after morning feeding. Results. In the fed phosphate-deprived rats (LPD and LPD + APD), serum phosphate levels were less (P < 0.05) and serum calcium levels were greater (P < 0.05) than in similar rats fasted overnight. In rats on the ND (ND and ND + APD), no differences were observed between fed and fasted rats. In phosphate-deprived rats, serum calcitriol levels were greater (LPD, P < 0.05) or tended to be greater (LPD + APD, P = 0.10) in the fed than in the fasted groups. In APD-treated rats. serum calcitriol values were greater than in rats not given APD whether rats were (I) fed or fasted, or (2) on an LPD dr ND. An inverse correlation was present between serum phosphate and serum calcitriol (r = -0.58, P = 0.001). In a stepwise regression model in which serum calcitriol was the dependent variable and independent variables were APD administration and serum calcium, phosphate, ind PTH. serum phosphate (r = 0.003) had an inverse and APD (P < 0.001) administration a direct effect on serum calcitriol (r(2) = 0.59). Conclusion. Calcitriol synthesis is rapidly inducible in rats during chronic phosphate deprivation, and the increase in serum calcitriol values is best attributed to feeding-induced decreases in serum phosphate. APD administration independently increases serum calcitriol levels in rats on normal and phosphate-deprived diets. Finally, whether our results in the rat are applicable to the clinical setting should be evaluated because in previous human studies of dietary phosphate restriction, serum calcitriol measurements were performed the morning after an overnight fast. C1 W Los Angeles Vet Affairs Med Ctr, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. RP Felsenfeld, AJ (reprint author), W Los Angeles Vet Affairs Med Ctr, Nephrol Sect 111L, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 49 TC 4 Z9 4 U1 0 U2 1 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD SEP PY 2000 VL 58 IS 3 BP 1016 EP 1022 DI 10.1046/j.1523-1755.2000.00259.x PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 351KE UT WOS:000089155700010 PM 10972666 ER PT J AU Jara, A Felsenfeld, AJ Bover, J Kleeman, CR AF Jara, A Felsenfeld, AJ Bover, J Kleeman, CR TI Chronic metabolic acidosis in azotemic rats on a high-phosphate diet halts the progression of renal disease SO KIDNEY INTERNATIONAL LA English DT Article DE bone; calcium; parathyroid hormone; hyperphosphatemia; chronic renal failure; diet; mineral metabolism ID BODY PROTEIN-DEGRADATION; D-DEFICIENT RATS; PARATHYROID-HORMONE; INORGANIC-PHOSPHATE; BONE HISTOMORPHOMETRY; CALCIUM-TRANSPORT; ION HOMEOSTASIS; FAILURE; PHOSPHORUS; HYPERPARATHYROIDISM AB Background. Hyperphosphatemia and metabolic acidosis are general features of advanced chronic renal failure (RF), and each may affect mineral metabolism. The goal of the present study was to evaluate the effect of chronic metabolic acidosis on the development of hyperparathyroidism and bone disease in normal and azotemic rats on a high-phosphate diet. Our assumption that the two groups of azotemic rats (acid-loaded vs. non-acid-loaded) would have the same degree of renal failure at the end of the study proved to be incorrect. Methods. Four groups of rats receiving a high-phosphate (1.2%), normal-calcium (0.6%) diet for 30 days were studied: (I) normal (N); (2) normal + acid (N + Ac) in which 1.5% ammonium chloride (NH4Cl) was added to the drinking water to induce acidosis; (3) RF, 5/6 nephrectomized rats; and (4) RF + acid (RF + Ac) in which 0.75% NH4Cl was added to the drinking water of 5/6 nephrectomized rats to induce acidosis. Results. At sacrifice, the arterial pH and serum bicarbonate were lowest in the RF + Ac group and were intermediate in the N + Ac group. Serum creatinine (0.76 +/- 0.08 vs. 1.15 +/- 0.08 mg/dL), blood urea nitrogen (52 +/- 8 vs. 86 +/- 13 mg/dL), parathyroid hormone (PTH; 180 +/- 50 vs. 484 +/- 51 pg/mL), and serum phosphate (7.46 +/- 0.60 vs. 12.87 +/- 1.4 mg/dL) values were less (P < 0.05), and serum calcium (9.00 +/- 0.28 vs. 7.75 +/- 0.25 mg/dL) values were greater (P < 0.05) in the RF + Ac group than in the RF group. The fractional excretion of phosphate (FEp) was greater (P < 0.05) in the two azotemic groups than in the two nonazotemic groups. In the azotemic groups, the FEp was similar even though PTH and serum phosphate values were less in the RF + Ac than in the RF group. NH4Cl-induced acidosis produced hypercalciuria in the N + Ac and RF + Ac groups. When acid-loaded (N + Ac and RF + Ac) and non-acid-loaded (N and RF) rats were combined as separate groups, serum phosphate and PTH values were less for a similarly elevated serum creatinine value in acid-loaded than in non-acid-loaded rats. Finally, the osteoblast surface was less in the N + Ac group than in the other groups. However, in the acid-loaded azotemic group (RF + Ac), the osteoblast surface was not reduced. Conclusions. The presence of chronic metabolic acidosis in 5/6 nephrectomized rats on a high-phosphate diet (I) protected against the progression of RF, (2) enhanced the renal clearance of phosphate, (3) resulted in a lesser degree of hyperparathyroidism, and (4) did not reduce the osteoblast surface. The combination of metabolic acidosis and phosphate loading may protect against the progression of RF and possibly bone disease because the harmful effects of acidosis and phosphate loading may be counterbalanced. C1 W Los Angeles Vet Affairs Med Ctr, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA USA. RP Felsenfeld, AJ (reprint author), W Los Angeles Vet Affairs Med Ctr, Nephrol Sect 111L, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 85 TC 38 Z9 38 U1 0 U2 3 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD SEP PY 2000 VL 58 IS 3 BP 1023 EP 1032 DI 10.1046/j.1523-1755.2000.00260.x PG 10 WC Urology & Nephrology SC Urology & Nephrology GA 351KE UT WOS:000089155700011 PM 10972667 ER PT J AU Leehey, DJ Singh, AK Alavi, N Singh, R AF Leehey, DJ Singh, AK Alavi, N Singh, R TI Role of angiotensin II in diabetic nephropathy SO KIDNEY INTERNATIONAL LA English DT Article; Proceedings Paper CT 4th Hyonam Kidney Laboratory International Symposium on Diabetic Kidney Disease Research - Where do We Stand at the Turn of the Century CY FEB 11-13, 2000 CL SEOUL, SOUTH KOREA SP Int Soc Nephrol, AstraZeneca, Baxter Korea, Boryung Pharmaceut Co Lt, Choogwae Pharma Corp, Gambro Korea, Hanwha Grp, Lilly Korea Ltd, MSD Korea Ltd DE diabetes; angiotensin; glucose; matrix ID HUMAN MESANGIAL CELLS; VASCULAR-PERMEABILITY FACTOR; ENDOTHELIAL GROWTH-FACTOR; MESSENGER-RNA EXPRESSION; CONVERTING ENZYME-INHIBITION; FACTOR-BETA; GLUCOSE; RAT; MATRIX; SYSTEM AB Considerable evidence suggests that the intrarenal renin-angiotensin system plays an important role in diabetic nephropathy. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II (Ang II) receptor blockers (ARBs) can attenuate progressive glomerulosclerosis in disease models and can slow disease progression in humans. Because agents that interfere with Ang II action may decrease glomerular injury without altering glomerular pressures, it has been suggested that Ang II has direct effects on glomerular cells to induce sclerosis independent of its hemodynamic actions. To study nonhemodynamic effects of Ang II on matrix metabolism, many investigators have used cell culture systems. Glucose and Ang II have been shown to produce similar effects on renal cells in culture. For instance, incubation of mesangial cells in high-glucose media or in the presence of Ang II stimulates matrix protein synthesis and inhibits degradative enzyme (e.g., collagenase, plasmin) activity. Glucose and Ang II also can inhibit proximal tubule proteinases. Glucose increases expression of the angiotensinogen gene in proximal tubule cells and Ang II production in primary mesangial cell culture, which indicates that high glucose itself can activate the renin-angiotensin system. The effects of glucose and Ang II on mesangial matrix metabolism may be mediated by transforming growth factor-beta (TGF-beta). Exposure of mesangial cells to glucose or Ang II increases TGF-beta expression and secretion. Their effects on matrix metabolism can be blocked by anti-TGF-beta antibody or ARBs such as losartan, which also prevents the glucose-induced increment in TGF-beta secretion. Taken together, these findings support the hypothesis that the high-glucose milieu of diabetes increases Ang II production by renal, and especially, mesangial cells, which results in stimulation of TGF-beta 1 secretion, leading to increased synthesis and decreased degradation of matrix proteins, thus producing matrix accumulation. This may be an important mechanism linking hyperglycemia and Ang II in the pathogenesis of diabetic nephropathy. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Loyola Univ, Sch Med, Maywood, IL 60153 USA. Hektoen Inst Med Res, Chicago, IL 60612 USA. Westside Vet Affairs Hosp, Chicago, IL USA. RP Leehey, DJ (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. NR 62 TC 57 Z9 65 U1 0 U2 1 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD SEP PY 2000 VL 58 SU 77 BP S93 EP S98 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 348PV UT WOS:000088994800015 ER PT J AU Ubel, PA Nord, E Gold, M Menzel, P Prades, JLP Richardson, J AF Ubel, PA Nord, E Gold, M Menzel, P Prades, JLP Richardson, J TI Improving value measurement in cost-effectiveness analysis SO MEDICAL CARE LA English DT Article DE cost-effectiveness analysis; quality-adjusted life-years; person tradeoff; rationing; disability; quality of life; ethics ID PERSON-TRADE-OFF; HEALTH-CARE PRIORITIES; UTILITY ANALYSIS; PREFERENCES; QUALITY; OREGON; EQUITY; QALYS; LIFE; DISCRIMINATION AB OBJECTIVE. Before cost-effectiveness analysis (CEA) tan fulfill its promise as a tool to guide health care allocation decisions, the method of incorporating societal values into CEA may need to be improved. DESIGN. The study design was a declarative exposition of potential fallacies in the theoretical underpinnings of CEA. Two values held by many people-preferences for giving priority to severely ill patients and preferences to avoid discrimination against people who have limited treatment potential because of disability or chronic illness-that are not currently incorporated into CEA are discussed. CONCLUSIONS. Traditional CEA, through the measurement of quality-adjusted life years (QALYs), is constrained because of a "QALY trap." If, for example, saving the life of a person with paraplegia is equally valuable as saving the life of a person without paraplegia, then current QALY methods force us to conclude that curing paraplegia brings no benefit. Basing cost-effectiveness measurement on societal values rather than QALYs may allow us to better capture public rationing preferences, thereby escaping the QALY trap. CEA can accommodate a wider range of such societal values about fairness in its measurements by amending its methodology. C1 Univ Penn, Div Gen Internal Med, Sch Med, Philadelphia, PA 19104 USA. Univ Penn, Vet Affairs Med Ctr, Sch Med, Philadelphia, PA 19104 USA. Natl Publ Hlth Inst, Oslo, Norway. CUNY, Sch Med, New York, NY USA. Pacific Lutheran Univ, Dept Philosophy, Tacoma, WA 98447 USA. Pompeu Fabra Univ, Dept Econ, Barcelona, Spain. Pompeu Fabra Univ, Ctr Hlth Econ, Barcelona, Spain. RP Ubel, PA (reprint author), Univ Penn, Div Gen Internal Med, Sch Med, 1223 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. RI pinto prades, jose luis/B-7069-2008 OI pinto prades, jose luis/0000-0002-9684-3410 NR 52 TC 35 Z9 35 U1 1 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD SEP PY 2000 VL 38 IS 9 BP 892 EP 901 DI 10.1097/00005650-200009000-00003 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 348GD UT WOS:000088976400003 PM 10982111 ER PT J AU Cummings, DE Schwartz, MW AF Cummings, DE Schwartz, MW TI Melanocortins and body weight: a tale of two receptors SO NATURE GENETICS LA English DT Editorial Material ID OBESITY; LEPTIN; MICE AB The phenotypes of mice lacking melanocortin-3 (Mcr3) and melanocortin4 receptors (Mc4r) demonstrate that these isoforms reduce body weight through distinct and complementary mechanisms. Mc4r regulates food intake and possibly energy expenditure, whereas Mc3r influences feed efficiency and the partitioning of fuel stores into fat. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98108 USA. Harborview Med Ctr, Seattle, WA 98108 USA. RP Cummings, DE (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98108 USA. RI Schwartz, Michael/H-9950-2012 NR 18 TC 47 Z9 53 U1 0 U2 3 PU NATURE AMERICA INC PI NEW YORK PA 345 PARK AVE SOUTH, NEW YORK, NY 10010-1707 USA SN 1061-4036 J9 NAT GENET JI Nature Genet. PD SEP PY 2000 VL 26 IS 1 BP 8 EP 9 DI 10.1038/79223 PG 2 WC Genetics & Heredity SC Genetics & Heredity GA 350AK UT WOS:000089078000005 PM 10973234 ER PT J AU Thannickal, TC Moore, RY Nienhuis, R Ramanathan, L Gulyani, S Aldrich, M Cornford, M Siegel, JM AF Thannickal, TC Moore, RY Nienhuis, R Ramanathan, L Gulyani, S Aldrich, M Cornford, M Siegel, JM TI Reduced number of hypocretin neurons in human narcolepsy SO NEURON LA English DT Article ID CANINE NARCOLEPSY; OREXIN; HYPOTHALAMUS; HAPLOTYPE; SYSTEMS; GENE AB Murine and canine narcolepsy can be caused by mutations of the hypocretin (Hcrt) (orexin) precursor or Hcrt receptor genes. In contrast to these animal models, most human narcolepsy is not familial, is discordant in identical twins, and has not been linked to mutations of the Hcrt system. Thus, the cause of human narcolepsy remains unknown. Here we show that human narcoleptics have an 85%-95% reduction in the number of Hcrt neurons. Melanin-concentrating hormone (MCH) neurons, which are intermixed with Hcrt cells in the normal brain, are not reduced in number, indicating that cell loss is relatively specific for Hcrt neurons. The presence of gliosis in the hypocretin cell region is consistent with a degenerative process being the cause of the Hcrt cell loss in narcolepsy. C1 Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Inst Brain Res, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, N Hills, CA 91343 USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Michigan, Med Ctr, Ann Arbor, MI 48109 USA. Harbor UCLA Med Ctr, Dept Pathol, Torrance, CA 90509 USA. RP Siegel, JM (reprint author), Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90024 USA. FU NHLBI NIH HHS [HL41370, HL6029C]; NINDS NIH HHS [NS14610] NR 28 TC 1081 Z9 1105 U1 4 U2 49 PU CELL PRESS PI CAMBRIDGE PA 1050 MASSACHUSETTES AVE, CIRCULATION DEPT, CAMBRIDGE, MA 02138 USA SN 0896-6273 J9 NEURON JI Neuron PD SEP PY 2000 VL 27 IS 3 BP 469 EP 474 DI 10.1016/S0896-6273(00)00058-1 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 359FR UT WOS:000089601300011 PM 11055430 ER PT J AU Davis, PJ Reeves, JL Hastie, BA Graff-Radford, SB Naliboff, BD AF Davis, PJ Reeves, JL Hastie, BA Graff-Radford, SB Naliboff, BD TI Depression determines illness conviction and pain impact: A structural equation modeling analysis SO PAIN MEDICINE LA English DT Article DE headache; orofacial pain; factor analysis; structural equation modeling; MMPI-2; MPI; BDI; VAS; depression ID LOW-BACK-PAIN; CHRONIC MUSCULOSKELETAL PAIN; VISUAL ANALOG SCALE; PSYCHOLOGICAL-FACTORS; COPING STRATEGIES; HEADACHE PATIENTS; CLUSTER-ANALYSIS; MMPI PROFILES; CONVERSION-V; INVENTORY AB Objective. The present study sought to derive an algorithm using factor analysis and structural equation modeling (SEM) to describe headache and orofacial pain patients using measures of behavioral and psychological functioning. This investigation further examined whether the underlying factor structure differed in 3 presumed distinct diagnostic categories: myofascial, neuropathic, and neurovascular pain. Design. The Minnesota Multiphasic Personality Inventory-2 ((MMPI-2), Multidimensional Pain Inventory (MPI), Beck Depression Inventory-II (BDI-II), and visual analog scale for functional limitation (VAS-FL) were administered to the subjects. A split group design was used. Exploratory factor analysis (EFA) was used to describe distinct factor domains in the first group. Confirmatory factor analysis (CFA) using SEM tested this structure in the second group and described causal relationships between the revealed (latent) factors. Analysis of variance (ANOVA) was used to test for differences in demographic variables and diagnostic group factor structure. Setting. The Pain Center is a comprehensive, multidisciplinary pain medicine program at Cedars Sinai Medical Center, Los Angeles, California. Subjects. Three hundred and ninety (N = 390) subjects were assigned to 1 of 3 diagnostic categories: myofascial pain syndrome, neuropathic pain, or neurovascular pain. Results. EFA revealed a 3-factor solution. The factors were labeled Depression, Illness Conviction, and Pain Impact, reflecting the content of their respective variables with highest loadings. CFA using SEM validated the 3-factor solution, and further revealed that Depression was a critical causal factor determining Illness Conviction and Pain Impact. No causal relationship was observed between Illness Conviction and Pain Impact. ANOVA found no differences in demographics. No difference in factor structure emerged for the 3 diagnostic categories. Conclusions. Analysis derived a 3-factor solution. The factors were Pain Impact, Illness Conviction, and Depression. SEM revealed the critical causal pathway showing that Depression determined Illness Conviction and Pain Impact. We conclude that the main target for pain treatment is depression. No differences in factor structure were found for the 3 diagnostic categories of myofascial, neuropathic, or neurovascular pain. This suggests that psychological processes are similar in chronic headache and orofacial pain patients despite their presumed distinct underlying pathophysiological mechanisms. SME is a powerful methodology to construct causal models that has been underutilized in the pain literature. C1 Alliant Univ, Fresno, CA USA. Univ Calif Los Angeles, Sch Dent, Sect Oral Med & Orofacial Pain, Los Angeles, CA 90024 USA. Cedars Sinai Med Ctr, Pain Ctr, Los Angeles, CA USA. Behav Med Network, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90024 USA. W Los Angeles VA Hlth Care Ctr, Los Angeles, CA USA. RP Reeves, JL (reprint author), Behav Med Network, POB 18157, Beverly Hills, CA 90209 USA. NR 64 TC 16 Z9 18 U1 2 U2 4 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 1526-2375 J9 PAIN MED JI Pain Med. PD SEP PY 2000 VL 1 IS 3 BP 238 EP 246 DI 10.1046/j.1526-4637.2000.00032.x PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 425EW UT WOS:000168278600007 PM 15101890 ER PT J AU Rosado, KE Pitt, MJ Siegal, GP AF Rosado, KE Pitt, MJ Siegal, GP TI Osteoblastoma: A mimic of osteosarcoma SO PEDIATRIC PATHOLOGY & MOLECULAR MEDICINE LA English DT Article DE bone tumor; neoplasm of bone; osteoblastoma; osteosarcoma ID OSTEOID OSTEOMA; PSEUDOMALIGNANT OSTEOBLASTOMA; BENIGN OSTEOBLASTOMA; CLASSIFICATION; FEATURES; SARCOMAS AB Osteoblastoma, a bone-forming neoplasm without metastatic potential, can be mistaken histologically for various benign and malignant primary neoplasms of bone or mimic nonneoplastic conditions, including osteoid osteoma, giant cell tumor of bone, aneurysmal bone cyst, and chondroblastoma [1]. The most important diagnostic distinction is to distinguish osteoblastoma from osteosarcoma. Although both lesions usually have characteristic clinical, radiologic, and histologic findings, in certain cases the distinction between both can be difficult. This is complicated by lesions that morphologically and biologically appear to exist at the interface between the two. In this review, we describe the characteristics of osteoblastomas and review criteria that can prove helpful in the distinction among the various pathologic entities. C1 Univ Alabama, Dept Pathol, Div Anat Pathol, Birmingham, AL 35233 USA. Univ Alabama, Dept Radiol, Birmingham, AL 35233 USA. Univ Alabama, Dept Cell Biol, Birmingham, AL 35233 USA. Univ Alabama, Dept Surg, Birmingham, AL 35233 USA. Birmingham VAMC, Birmingham, AL USA. RP Siegal, GP (reprint author), Univ Alabama, Dept Pathol, Div Anat Pathol, 506 Kracke Bldg, Birmingham, AL 35233 USA. RI Siegal, Gene/A-8653-2009 NR 39 TC 6 Z9 6 U1 0 U2 0 PU TAYLOR & FRANCIS LTD PI LONDON PA 11 NEW FETTER LANE, LONDON EC4P 4EE, ENGLAND SN 1522-7952 J9 PEDIATR PATHOL MOL M JI Pediatr. Pathol. Mol. Med. PD SEP PY 2000 VL 19 IS 5 BP 305 EP 322 PG 18 WC Pathology; Pediatrics SC Pathology; Pediatrics GA 374EW UT WOS:000165332300002 ER PT J AU Sipols, AJ Stuber, GD Klein, SN Higgins, MS Figlewicz, DP AF Sipols, AJ Stuber, GD Klein, SN Higgins, MS Figlewicz, DP TI Insulin and raclopride combine to decrease short-term intake of sucrose solutions SO PEPTIDES LA English DT Article DE insulin; dopamine; rats; food intake; reward ID DOPAMINE TRANSPORTER; FOOD-INTAKE; ENDOCRINE REGULATION; MESOLIMBIC DOPAMINE; MESSENGER-RNA; CORN-OIL; RATS; TRANSMISSION; BEHAVIOR; REWARD AB We have previously reported that the hormone insulin can modulate synaptic function of dopamine neurons. To evaluate whether insulin can alter performance of a task which is dependent on intact dopaminergic signaling, we tested rats in a five minute lick rate task, with a range of concentrations of sucrose or oil solutions. Rats received either ip (t - 15 min) saline or the D2 receptor antagonist raclopride (50 mug/kg), and intraventricular (t - 4 h) saline or insulin (5 mU). Although ineffective on its own, insulin combined with raclopride treatment resulted in significant suppression of sucrose lick rates compared to the saline/saline group. The overall results are consistent with our hypothesis that insulin may modify performance in tasks that are dependent on dopaminergic signaling. (C) 2000 Elsevier Science Inc. All rights reserved. C1 VA Puget Sound Hlth Care Syst, Div Endocrinol & Metab, Seattle, WA 98108 USA. Latvian State Univ, Fac Med, Inst Clin & Expt Med, LV-1063 Riga, Latvia. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. RP Figlewicz, DP (reprint author), VA Puget Sound Hlth Care Syst, Div Endocrinol & Metab, 1660 So Columbian Way, Seattle, WA 98108 USA. RI Stuber, Garret/E-1160-2011 FU NIDDK NIH HHS [DK40963]; NINDS NIH HHS [T32 NS007431] NR 35 TC 29 Z9 31 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0196-9781 J9 PEPTIDES JI Peptides PD SEP PY 2000 VL 21 IS 9 BP 1361 EP 1367 DI 10.1016/S0196-9781(00)00279-5 PG 7 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy GA 371WJ UT WOS:000165202000008 PM 11072123 ER PT J AU De Giorgio, R Arakawa, J Wetmore, CJ Sternini, C AF De Giorgio, R Arakawa, J Wetmore, CJ Sternini, C TI Neurotrophin-3 and neurotrophin receptor immunoreactivity in peptidergic enteric neurons SO PEPTIDES LA English DT Article DE nerve growth factor; neurotrophins; tyrosine kinase receptor; peptide-containing neurons; enteric nervous system ID NERVE GROWTH-FACTOR; TYROSINE PROTEIN-KINASE; FETAL-RAT GUT; GUINEA-PIG; SYSTEM DEVELOPMENT; ENDOCRINE-CELLS; SMALL-INTESTINE; SUBSTANCE-P; TRK FAMILY; IN-VITRO AB In the rat small intestine, neurotrophin-3 immunoreactivity was identified in ganglion cells and in processes mostly innervating the mucosa and occasionally the muscle layer and vasculature. The vast majority of neurotrophin-3 immunoreactive neurons contained vasoactive intestinal polypeptide (VIP), but not substance P or related tachykinin (SP/TK). Neurotrophin receptors visualized by pan-trk immunoreactivity were found in numerous ganglion cells of both plexuses and in nerve processes in the intestinal wall. Pan-trk submucosal neurons contained VIP (36%) or SP/TK-IR (47%). Pan-trk myenteric neurons contained VIP-IR (57%) or SP/TK (27%). Our data suggest that neurotrophin-3 and neurotrophin receptors may be involved in the maintenance of enteric neuronal circuits, transmission and phenotypic expression. (C) 2000 Elsevier Science Inc. All rights reserved. C1 Univ Bologna, Dept Internal Med & Gastroenterol, Bologna, Italy. Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Div Digest Dis, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Div Digest Dis, Dept Neurobiol, Los Angeles, CA 90073 USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. St Jude Childrens Res Hosp, Dept Dev Neurobiol, Memphis, TN 38105 USA. RP Sternini, C (reprint author), VACLAHS, CURE Bldg 115,Rm 224,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM csternin@ucla.edu OI De Giorgio, Roberto/0000-0003-0867-5873 FU NIDDK NIH HHS [DK51455, DK41301] NR 43 TC 15 Z9 15 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-9781 J9 PEPTIDES JI Peptides PD SEP PY 2000 VL 21 IS 9 BP 1421 EP 1426 DI 10.1016/S0196-9781(00)00286-2 PG 6 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy GA 371WJ UT WOS:000165202000015 PM 11072130 ER PT J AU Jones, L Brazel, D Peskind, ER Morelli, T Raskind, MA AF Jones, L Brazel, D Peskind, ER Morelli, T Raskind, MA TI Group therapy program for African-American veterans with posttraumatic stress disorder SO PSYCHIATRIC SERVICES LA English DT Article; Proceedings Paper CT 4th African-American Conference on Posttraumatic Stress Disorder CY SEP 13, 1999 CL WASHINGTON, D.C. ID ISSUES AB A Vet Center's group therapy treatment program for African-American veterans with posttraumatic stress disorder (PTSD) has met regularly and expanded since it was established in 1984, Program attributes described by participants as particularly helpful include facilitating open communication of thoughts and feelings among African-American men; providing support for coping with the intrapsychic, social, and economic effects of racism; increasing knowledge about the causes, consequences, and treatment of PTSD; and decreasing emotional and social isolation. The program appears to be a useful treatment for African-American veterans with PTSD. C1 VA Puget Sound Healthcare Syst, Mental Hlth Serv S116, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, NW Network Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. Univ Hawaii, Honolulu, HI 96822 USA. RP Jones, L (reprint author), VA Puget Sound Healthcare Syst, Mental Hlth Serv S116, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 10 TC 6 Z9 8 U1 1 U2 3 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1075-2730 J9 PSYCHIATR SERV JI Psychiatr. Serv. PD SEP PY 2000 VL 51 IS 9 BP 1177 EP 1179 DI 10.1176/appi.ps.51.9.1177 PG 3 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 350MK UT WOS:000089105100017 PM 10970924 ER PT J AU Maisto, SA Conigliaro, J McNeil, M Kraemer, K Kelley, ME AF Maisto, SA Conigliaro, J McNeil, M Kraemer, K Kelley, ME TI An empirical investigation of the factor structure of the AUDIT SO PSYCHOLOGICAL ASSESSMENT LA English DT Article ID DIAGNOSTIC INTERVIEW SCHEDULE; ALCOHOL-USE DISORDERS; DEPENDENCE AB This study investigated the Alcohol Use Disorders Identification Test's (AUDIT) factor structure and psychometric properties. The factor structure was derived from a sample of 7,035 men and women primary care patients. A principal components analysis identified 2 factors in the AUDIT data and was supported in a confirmatory factor analysis (CFA). The 2 factors were Dependence/Consequences and Alcohol Consumption. The CFA also provided support for a 3-factor model whose factors (Alcohol Consumption, Alcohol Dependence, and Related Consequences) matched those proposed by the AUDIT'S developers. Psychometric indexes were determined by use of the baseline and 12-month follow-up data of 301 men and women who entered a clinical trial. The results showed that the 2 factors had good reliability. Validity tests supported the interpretation of what the 2 factors measure, its implications for relationships to other variables, and the comparability of the 2- and 3-factor models. C1 Syracuse Univ, Dept Psychol, Syracuse, NY 13244 USA. Univ Pittsburgh, Western Psychiat Inst & Clin, Pittsburgh, PA 15260 USA. Vet Affairs Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Ctr Res Hlth Care, Pittsburgh, PA USA. RP Maisto, SA (reprint author), Syracuse Univ, Dept Psychol, 430 Huntington Hall, Syracuse, NY 13244 USA. FU NIAAA NIH HHS [5K08-AA00235, AA1029] NR 19 TC 81 Z9 84 U1 0 U2 3 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 1040-3590 J9 PSYCHOL ASSESSMENT JI Psychol. Assess. PD SEP PY 2000 VL 12 IS 3 BP 346 EP 353 DI 10.1037//1040-3590.12.3.346 PG 8 WC Psychology, Clinical SC Psychology GA 356JG UT WOS:000089439700016 PM 11021159 ER PT J AU Alterman, AI McDermott, PA Cook, TG Cacciola, JS McKay, JR McLellan, AT Rutherford, MJ AF Alterman, AI McDermott, PA Cook, TG Cacciola, JS McKay, JR McLellan, AT Rutherford, MJ TI Generalizability of the clinical dimensions of the Addiction Severity Index to nonopioid-dependent patients SO PSYCHOLOGY OF ADDICTIVE BEHAVIORS LA English DT Article AB Clinical dimensions (CDs) for the Addiction Severity Index recently have been established for application among opioid-dependent patients in methadone treatment (P. A. McDermott et al., 1996). This article examines the generalizability of the CDs to other substance-dependent patients. A sample of 2,027 adult nonopioid-dependent patients was identified; it comprised 581 primarily cocaine-dependent, 544 primarily alcohol-dependent, and 803 polydrug-dependent patients and 99 patients who were dependent on other varied drugs. Generality of dimensions was assessed through confirmatory components analysis, structural congruence, internal consistency, and variance partitioning in higher order factoring. The CDs were found generalizable overall and to specific nonopioid-dependent subgroups, and across patient gender and age, and to African American and White patients. Preliminary concurrent and predictive validity data supported the CD structure. C1 Univ Penn, Treatment Res Ctr, Sch Med, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Penn, Grad Sch Educ, Philadelphia, PA 19104 USA. Univ Washington, Alcohol & Drug Inst, Seattle, WA 98195 USA. RP Alterman, AI (reprint author), Univ Penn, Treatment Res Ctr, Sch Med, 3900 Chestnut St, Philadelphia, PA 19104 USA. FU NIDA NIH HHS [DA-05858, DA05186, DA060142] NR 16 TC 17 Z9 18 U1 1 U2 2 PU EDUCATIONAL PUBLISHING FOUNDATION PI WASHINGTON PA 750 FIRST ST, NE, WASHINGTON, DC 20002-4242 USA SN 0893-164X J9 PSYCHOL ADDICT BEHAV JI Psychol. Addict. Behav. PD SEP PY 2000 VL 14 IS 3 BP 287 EP 294 DI 10.1037//0893-164X.14.3.287 PG 8 WC Substance Abuse; Psychology, Multidisciplinary SC Substance Abuse; Psychology GA 352JW UT WOS:000089212600007 PM 10998954 ER PT J AU Hauser, P Soler, R Reed, S Kane, R Gulati, M Khosla, J Kling, MA Valentine, AD Meyers, CA AF Hauser, P Soler, R Reed, S Kane, R Gulati, M Khosla, J Kling, MA Valentine, AD Meyers, CA TI Prophylactic treatment of depression induced by interferon-alpha SO PSYCHOSOMATICS LA English DT Article ID THERAPY; MOOD C1 Baltimore VA Med Ctr, Joint VA Univ Mood Disorders Programs, Psychiat Serv, Baltimore, MD 21201 USA. Portland VA Med Ctr, Dept Psychiat, Portland, OR USA. Univ Maryland, Med Ctr, Dept Psychiat, Baltimore, MD 21201 USA. Univ Texas, MD Anderson Canc Ctr, Dept Neurooncol, Houston, TX 77030 USA. RP Baltimore VA Med Ctr, Joint VA Univ Mood Disorders Programs, Psychiat Serv, 10 N Greene St, Baltimore, MD 21201 USA. RI Kling, Mitchel/F-4152-2010 OI Kling, Mitchel/0000-0002-2232-1409 NR 12 TC 44 Z9 49 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0033-3182 J9 PSYCHOSOMATICS JI Psychosomatics PD SEP-OCT PY 2000 VL 41 IS 5 BP 439 EP 441 DI 10.1176/appi.psy.41.5.439 PG 3 WC Psychiatry; Psychology SC Psychiatry; Psychology GA 349CD UT WOS:000089025500011 PM 11015632 ER PT J AU Rosen, T AF Rosen, T TI Hazardous hedgehogs SO SOUTHERN MEDICAL JOURNAL LA English DT Article AB The African pygmy hedgehog has recently become a fashionable exotic pet in the United States, particularly in the South. As illustrated by the three cases reported, this mammalian insectivore can be a carrier of fungi that cause human dermatomycoses. The African pygmy hedgehog has also been associated with contact urticaria and human salmonellosis. C1 Baylor Coll Med, VA Med Ctr, Dept Dermatol, Houston, TX 77030 USA. RP Rosen, T (reprint author), 6560 Fannin,Suite 802, Houston, TX 77030 USA. OI Rosen, Ted/0000-0002-5946-5529 NR 26 TC 12 Z9 14 U1 0 U2 2 PU SOUTHERN MEDICAL ASSN PI BIRMINGHAM PA 35 LAKESHORE DR PO BOX 190088, BIRMINGHAM, AL 35219 USA SN 0038-4348 J9 SOUTHERN MED J JI South.Med.J. PD SEP PY 2000 VL 93 IS 9 BP 936 EP 938 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 353LC UT WOS:000089274800023 PM 11005362 ER PT J AU Hatsukami, TS Ross, R Polissar, NL Yuan, C AF Hatsukami, TS Ross, R Polissar, NL Yuan, C TI Visualization of fibrous cap thickness and rupture in human atherosclerotic carotid plaque in vivo with high-resolution magnetic resonance imaging SO CIRCULATION LA English DT Article DE atherosclerosis; magnetic resonance imaging; imaging ID OPTICAL COHERENCE TOMOGRAPHY; CORONARY-ARTERY DISEASE; ACUTE MYOCARDIAL-INFARCTION; INTRAVASCULAR ULTRASOUND; IN-VIVO; CONVENTIONAL ANGIOGRAPHY; STENOSIS; PROGRESSION; MORPHOLOGY; THROMBOSIS AB Background-The results of studies of advanced lesions of atherosclerosis suggest that the thickness of the fibrous cap that overlies the necrotic core distinguishes the stable lesion from one that is at high risk for rupture and thromboembolic events. We have developed a high-resolution MRI technique that can identify the fine structure of the lesion, including the fibrous cap, in vivo. The aim of the present study was to determine the agreement between in vivo MRI and lesion architecture as seen on histology and gross tissue examination to identify fibrous cap thickness and rupture. Methods and Results-Twenty-two subjects who were scheduled for carotid endarterectomy underwent MRI with a 3-dimensional multiple overlapping thin slab angiography protocol. The appearance of the fibrous cap was categorized as (1) an intact, thick, (2) an intact, thin, or (3) a ruptured fibrous cap on MRI, gross, and histological sections. Thirty-six sites were available for comparison between MRI and histology. There was a high level of agreement between MRI and histological findings: 89% agreement, kappa (95% CI) = 0.83 (0.67 to 1.0), weighted kappa = 0.87. Spearman's correlation coefficient was 0.88 (significant to the 0.01 level). Conclusions-These findings indicate that high-resolution MRI with a 3-dimensional multiple overlapping thin slab angiography protocol is capable of distinguishing intact, thick fibrous caps from intact thin and disrupted caps in atherosclerotic human carotid arteries in vivo. This noninvasive technique has the potential to permit studies that examine the relationship between fibrous cap changes and clinical outcome and to permit trials that evaluate therapy intended to "stabilize" the fibrous cap. C1 VA Puget Sound Hlth Care Syst, Surg Serv 112, Seattle, WA 98108 USA. Mt Whisper Light Stat Consulting, Seattle, WA USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. Univ Washington, Dept Radiol, Seattle, WA 98195 USA. RP Hatsukami, TS (reprint author), VA Puget Sound Hlth Care Syst, Surg Serv 112, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NHLBI NIH HHS [R01-HL-60213, R29-HL-56874] NR 41 TC 374 Z9 397 U1 2 U2 15 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD AUG 29 PY 2000 VL 102 IS 9 BP 959 EP 964 PG 6 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 348GK UT WOS:000088977000014 PM 10961958 ER PT J AU Chow, SY Moul, J Tobias, CA Himes, BT Liu, Y Obrocka, M Hodge, L Tessler, A Fischer, I AF Chow, SY Moul, J Tobias, CA Himes, BT Liu, Y Obrocka, M Hodge, L Tessler, A Fischer, I TI Characterization and intraspinal grafting of EGF/bFGF-dependent neurospheres derived from embryonic rat spinal cord SO BRAIN RESEARCH LA English DT Article DE precursor; progenitor; stein cell; transplantation; BDNF; retinoic acid ID CENTRAL-NERVOUS-SYSTEM; NEURAL STEM-CELLS; FIBROBLAST GROWTH-FACTOR; PROGENITOR CELLS; NEURONAL PRECURSORS; SUBEPENDYMAL CELLS; IN-VIVO; DIFFERENTIATION; CNS; INJURY AB Recent advances in the isolation and characterization of neural precursor cells suggest that they have properties that would make them useful transplants for the treatment of central nervous system disorders. We demonstrate here that spinal cord cells isolated from embryonic day 13 Sprague-Dawley and Fischer 344 rats possess characteristics of precursor cells. They proliferate as undifferentiated neurospheres in the presence of EGF and bFGF and can be maintained in vitro or frozen, expanded and induced to differentiate into both neurons and glia. Exposure of these cells to serum in the absence of EGF and bFGF promotes differentiation into astrocytes; treatment with retinoic acid promotes differentiation into neurons. Spinal cord cells labeled with a nuclear dye or a recombinant adenovirus vector carrying the lacZ gene survive grafting into the injured spinal cord of immunosuppressed Sprague-Dawley rats and non-immunosuppressed Fischer 334 rats for up to 4 months following transplantation. Ln the presence of exogenously supplied BDNF, the grafted cells differentiate into both neurons and glia. These spinal cord cell grafts are permissive for growth by several populations of host axons, especially when combined with exogenous BDNF administration, as demonstrated by penetration into the graft of axons immunopositive for 5-HT and CGRP. Thus, precursor cells isolated from the embryonic spinal cord of rats, expanded in culture and genetically modified, are a promising type of transplant for repair of the injured spinal cord. (C) 2000 Elsevier Science B.V. All rights reserved. C1 Med Coll Penn & Hahnemann Univ, Dept Neurobiol & Anat, Philadelphia, PA 19129 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Chow, SY (reprint author), Med Coll Penn & Hahnemann Univ, Dept Neurobiol & Anat, 3300 Henry Ave, Philadelphia, PA 19129 USA. RI Fischer, Itzhak/D-1080-2012 OI Fischer, Itzhak/0000-0003-3187-8740 FU NICHD NIH HHS [HD07467]; NINDS NIH HHS [NS10090, NS24707] NR 69 TC 111 Z9 127 U1 0 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD AUG 25 PY 2000 VL 874 IS 2 BP 87 EP 106 DI 10.1016/S0006-8993(00)02443-4 PG 20 WC Neurosciences SC Neurosciences & Neurology GA 350NK UT WOS:000089107800001 PM 10960593 ER PT J AU Wang, LX Barachina, MD Martinez, V Wei, JY Tache, Y AF Wang, LX Barachina, MD Martinez, V Wei, JY Tache, Y TI Synergistic interaction between CCK and leptin to regulate food intake SO REGULATORY PEPTIDES LA English DT Article DE cholecystokinin; feeding behavior; vagus; satiety; body weight; gastric emptying; nucleus tractus solitarius; paraventricular nucleus of the hypothalamus ID CORTICOTROPIN-RELEASING HORMONE; C-FOS EXPRESSION; BODY-WEIGHT REGULATION; CENTRAL-NERVOUS-SYSTEM; OBESE GENE; PARAVENTRICULAR NUCLEUS; PANCREATIC GLUCAGON; ENERGY-BALANCE; OB PROTEIN; BRAIN-STEM AB Leptin administered (either intracerebroventricularly, icv, or intraperitoneally, ip) acts in synergy with CCK to suppress food intake and body weight in lean mice or rats. The potentiating effect induced by the co-injection of ip CCK and leptin to inhibit food consumption in mice is mediated by the CCK-A receptor and capsaicin sensitive afferents. In vitro, studies: in rats showed that a subset of gastric vagal afferent fibers responded to leptin injected directly into the gastric artery only after a prior intra-arterial CCK injection. Moreover, the tonic activity of gastric-related neurons in the nucleus tractus solitarius (NTS) increased when leptin was delivered into the gastric chamber of an in vitro stomach-brainstem preparation. CCK co-injected with leptin potentiated Fos expression selectively in the area postrema, NTS and paraventricular nucleus of the hypothalamus (PVN), which points to the PVN as part of the afferent and efferent limbs of the circuitry involved in the synergistic interaction between leptin and CCK. The dampening of CCK or leptin inhibitory action on ingestive behavior when either factor is not present or their receptors are non functional supports the notion that such leptin-CCK interaction may have a physiological relevance. These observations provide a mean through which leptin and CCK integrate short- and mid-term meal-related input signals into long-term control of energy balance. (C) 2000 Elsevier Science B.V. All rights reserved. C1 Univ Calif Los Angeles, Digest Dis Res Ctr, CURE, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Brain Res Inst, Los Angeles, CA 90073 USA. Univ Valencia, Sch Med, Dept Pharmacol, Valencia, Spain. CEU San Pablo, Sch Vet, Dept Physiol, Valencia 46113, Spain. RP Wang, LX (reprint author), Univ Calif Los Angeles, Digest Dis Res Ctr, CURE, Bldg 115,Room 203,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Martinez, Vicente/N-1189-2014 FU NIDDK NIH HHS [DK-41301, DK-30110, DK 48476] NR 78 TC 83 Z9 85 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-0115 J9 REGUL PEPTIDES JI Regul. Pept. PD AUG 25 PY 2000 VL 92 IS 1-3 SI SI BP 79 EP 85 DI 10.1016/S0167-0115(00)00153-1 PG 7 WC Endocrinology & Metabolism; Physiology SC Endocrinology & Metabolism; Physiology GA 368CR UT WOS:000090100500012 PM 11024569 ER PT J AU MacLean, CH Louie, R Leake, B McCaffrey, DF Paulus, HE Brook, RH Shekelle, PG AF MacLean, CH Louie, R Leake, B McCaffrey, DF Paulus, HE Brook, RH Shekelle, PG TI Quality of care for patients with rheumatoid arthritis SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; ASSOCIATION TASK-FORCE; PRACTICE GUIDELINES; UNITED-STATES; PHYSICIAN MASTERFILE; DEATH; SENSITIVITY; MANAGEMENT; MAMMOGRAPHY; IMPROVEMENT AB Context Patients with rheumatoid arthritis are at risk for substantial morbidity because of their arthritis and premature mortality due to comorbid diseases. However, little is known about the quality of the health care that these patients receive. Objective To assess the quality of the health care that rheumatoid arthritis patients receive for their arthritis, comorbid diseases, and health care maintenance and to determine the effect of patterns of specialty care on quality. Design, Setting, and Participants Historical cohort study of 1355 adult rheumatoid arthritis patients en rolled in the fee-for-service or discounted fee-for-service plans of a nationwide US insurance company, Patients were identified and followed up through administrative data between 1991 and 1995. Main Outcome Measures Quality scores for arthritis, comorbid disease, and health care maintenance were developed from performance on explicit process measures that related to each of these domains and described the percentage of indicated health care processes performed within each domain during each person-year of the study. Results During 4598 person-years of follow-up, quality scores were 62% (95% confidence interval [CI], 61%-64%) for arthritis care, 52% (95% CI, 49%-55%) for comorbid disease care, and 42% (95% CI, 40%-43%) for health care maintenance. Across domains, care patterns including relevant specialists yielded performance scores 30% to 187% higher than those that did not (P<.001) and 45% to 67% of person-years were associated with patterns of care that did not include a relevant specialist. Presence of primary care without specialty care yielded health care maintenance scores that were 43% higher than those for patterns that included neither primary nor relevant specialty care (P<.001). Conclusions In this population, health care quality appears to be suboptimal for arthritis, comorbid disease, and health care maintenance. Patterns of care that included relevant specialists were associated with substantially higher quality across all domains. Patterns that included generalists were associated with substantially higher quality health care maintenance than patterns that included neither a generalist nor a relevant specialist. The optimal roles of primary care physicians and specialists in the care of patients with complex conditions should be reassessed. C1 Univ Calif Los Angeles, Div Rheumatol, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90095 USA. RAND Corp, Hlth Program, Santa Monica, CA USA. Greater Los Angeles VA Hlth Care Syst, Los Angeles, CA USA. Vet Affairs Hlth Serv Res & Dev Serv, Los Angeles, CA USA. RP MacLean, CH (reprint author), Univ Calif Los Angeles, Div Rheumatol, Dept Med, 1000 Vet Ave,Room 32-59, Los Angeles, CA 90095 USA. FU NIAMS NIH HHS [P60-AR36834] NR 60 TC 130 Z9 130 U1 0 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD AUG 23 PY 2000 VL 284 IS 8 BP 984 EP 992 DI 10.1001/jama.284.8.984 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 344PX UT WOS:000088769000025 PM 10944644 ER PT J AU Spielberg, F Critchlow, C Vittinghoff, E Coletti, AS Sheppard, H Mayer, KH Metzger, D Judson, FN Buchbinder, S Chesney, M Gross, M AF Spielberg, F Critchlow, C Vittinghoff, E Coletti, AS Sheppard, H Mayer, KH Metzger, D Judson, FN Buchbinder, S Chesney, M Gross, M CA HIV Early Detection Study Gp TI Home collection for frequent HIV testing: acceptability of oral fluids, dried blood spots and telephone results SO AIDS LA English DT Article DE dried blood spots; early HIV detection; HIV diagnostic tests; home specimen collection; oral fluids; telephone counseling ID LONGITUDINAL DATA-ANALYSIS; ANTIRETROVIRAL THERAPY; INFECTION; AIDS; TIME AB Objective: To assess the feasibility and acceptability of bimonthly home oral fluid (OF) and dried blood spot (DBS) collection for HIV testing among high-risk individuals. Design: A total of 241 participants [including men who have sex with men (MSM), injecting drug users (IDU), and women at heterosexual risk] were recruited from a randomly selected subset of study participants enrolled at four sites in the HIV Network for Prevention Trials (HIVNET) cohort, and assigned at random to bimonthly home collection of OF or DBS specimens over a 6 month interval. Participants could select telephone calls or clinic visits to receive HIV test results. Methods: Bimonthly specimens were tracked for adherence to the schedule, were evaluated for adequacy for testing, and tested using antibody assays and polymerase chain reaction (PCR) for DBS. The acceptability of bimonthly home OF and DBS collection and telephone counseling was assessed in an end-of-study questionnaire. Results: The laboratory received 96 and 90% of expected OF and DBS specimens, respectively; 99% of each specimen type was adequate for testing. Almost all (95%) participants chose results disclosure by telephone. The majority of participants (85%) reported that bimonthly testing did not make them worry more about HIV, and almost all (98%) judged that with bimonthly testing their risk behavior remained the same (77%) or became less risky (21%). C1 Univ Washington, Harborview Med Ctr, Ctr AIDS & STD, Dept Family Med, Seattle, WA 98104 USA. Fred Hutchinson Canc Res Ctr, HIVNET Stat Ctr, Seattle, WA 98104 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. ABT Associates Inc, Cambridge, MA 02138 USA. ABT Associates Inc, Bethesda, MD USA. Calif Dept Hlth Serv, Berkeley, CA 94704 USA. Brown Univ, Mem Hosp Rhode Isl, Sch Med, Pawtucket, RI 02860 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. Denver Dept Publ Hlth, Denver, CO USA. San Francisco Dept Publ Hlth, AIDS Off, San Francisco, CA USA. Univ Calif San Francisco, Ctr AIDS Prevent Studies, San Francisco, CA 94143 USA. RP Spielberg, F (reprint author), Univ Washington, Harborview Med Ctr, Ctr AIDS & STD, Dept Family Med, 325 9th Ave,3EC44,Box 359931, Seattle, WA 98104 USA. RI Metzger, David/D-9499-2012 FU PHS HHS [N01-A1-45200, N01-A1-35176] NR 26 TC 33 Z9 33 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD AUG 18 PY 2000 VL 14 IS 12 BP 1819 EP 1828 DI 10.1097/00002030-200008180-00018 PG 10 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 348RN UT WOS:000089000400018 PM 10985320 ER PT J AU Bookheimer, SY Strojwas, MH Cohen, MS Saunders, AM Pericak-Vance, MA Mazziotta, JC Small, GW AF Bookheimer, SY Strojwas, MH Cohen, MS Saunders, AM Pericak-Vance, MA Mazziotta, JC Small, GW TI Patterns of brain activation in people at risk for Alzheimer's disease SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID CEREBRAL BLOOD-FLOW; E TYPE-4 ALLELE; APOLIPOPROTEIN-E; SENSORY STIMULATION; EPSILON-4 ALLELE; TEMPORAL-LOBE; MEMORY; PERFORMANCE; ASSOCIATION; METABOLISM AB Background: The epsilon 4 allele of the apolipoprotein E gene (APOE) is the chief known genetic risk factor for Alzheimer's disease, the most common cause of dementia late in life. To determine the relation between brain responses to tasks requiring memory and the genetic risk of Alzheimer's disease, we performed APOE genotyping and functional magnetic resonance imaging (MRI) of the brain in older persons with intact cognition. Methods: We studied 30 subjects (age, 47 to 82 years) who were neurologically normal, of whom 16 were carriers of the APOE epsilon 4 allele and 14 were homozygous for the APOE epsilon 3 allele. The mean age and level of education were similar in the two groups. Patterns of brain activation during functional MRI scanning were determined while subjects memorized and recalled unrelated pairs of words and while subjects rested between such periods. Memory was reassessed in 14 subjects two years later. Results: Both the magnitude and the extent of brain activation during memory-activation tasks in regions affected by Alzheimer's disease, including the left hippocampal, parietal, and prefrontal regions, were greater among the carriers of the APOE epsilon 4 allele than among the carriers of the APOE epsilon 3 allele. During periods of recall, the carriers of the APOE epsilon 4 allele had a greater average increase in signal intensity in the hippocampal region (1.03 percent vs. 0.62 percent, P<0.001) and a greater mean (+/-SD) number of activated regions throughout the brain (15.9+/-6.2 vs. 9.4+/-5.5, P = 0.005) than did carriers of the APOE epsilon 3 allele. Longitudinal assessment after two years indicated that the degree of base-line brain activation correlated with degree of decline in memory. Conclusions: Patterns of brain activation during tasks requiring memory differ depending on the genetic risk of Alzheimer's disease and may predict a subsequent decline in memory. (N Engl J Med 2000;343:450-6.) (C)2000, Massachusetts Medical Society. C1 Univ Calif Los Angeles, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Radiol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Mol & Mol Pharmacol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Brain Mapping Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Alzheimers Dis Res Ctr, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Ctr Aging, Los Angeles, CA 90024 USA. Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Small, GW (reprint author), Univ Calif Los Angeles, Inst Neuropsychiat, Dept Psychiat & Biobehav Sci, 88-201,760 Westwood Plaza, Los Angeles, CA 90024 USA. RI Cohen, Mark/C-6610-2011 OI Cohen, Mark/0000-0001-6731-4053 FU NIA NIH HHS [R01 AG013308, AG13308, P30 AG010123, P30 AG010123-03, P50 AG005128, P50 AG005128-21, P60 AG011268, P60 AG011268-07, R01 AG013308-13, U24 AG021886]; NIMH NIH HHS [MH52453, R01 MH052453, R01 MH052453-05]; NINDS NIH HHS [P01 NS026630, R01 NS031153, R01 NS031153-14] NR 34 TC 779 Z9 795 U1 9 U2 48 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD AUG 17 PY 2000 VL 343 IS 7 BP 450 EP 456 DI 10.1056/NEJM200008173430701 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 344FC UT WOS:000088747700001 PM 10944562 ER PT J AU Hazzard, WR AF Hazzard, WR TI The department of internal medicine: Hub of the academic health center response to the aging imperative SO ANNALS OF INTERNAL MEDICINE LA English DT Article AB In the 21st century, geriatrics will increasingly dominate U.S. health care as the median age of the population progressively increases. Academic departments of geriatrics have been created in nations that have already experienced this shift. As an alternative strategy that builds on traditional strengths of academic medicine in the United States, departments of internal medicine should lead a multidepartmental, pan-institutional response to the aging imperative. Recognition of gerontology and geriatric medicine as central to the missions of internal medicine in clinical care, education, and research must be increased. In the process, academic departments of internal medicine will develop a high level of geriatric expertise and will launch many programs that address this challenge. Successful development of geriatric programs will serve as a catalyst to strengthen the integration among and between generalists and subspecialists. This will entail developing optimal sites and systems of geriatric care-at different levels of care and over time-that can enhance the geriatric education of medical students, residents, fellows, and practicing physicians. The study of aging and geriatric health care will also become an integral part of departmental research, in its subspecialty divisions as well as its divisions of general internal medicine and geriatrics. This strategy is urgently recommended as both a challenge and an opportunity for all departments of internal medicine. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Hazzard, WR (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 4 TC 15 Z9 16 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD AUG 15 PY 2000 VL 133 IS 4 BP 293 EP 296 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 346NG UT WOS:000088877500007 PM 10929171 ER PT J AU Keire, DA Kobayashi, M Solomon, TE Reeve, JR AF Keire, DA Kobayashi, M Solomon, TE Reeve, JR TI Solution structure of monomeric peptide YY supports the functional significance of the PP-fold SO BIOCHEMISTRY LA English DT Article ID NUCLEAR-MAGNETIC-RESONANCE; HUMAN NEUROPEPTIDE-Y; PANCREATIC-POLYPEPTIDE; MOLECULAR-STRUCTURE; SECONDARY STRUCTURE; RECEPTOR SUBTYPES; NMR-SPECTROSCOPY; BINDING; EXPRESSION; CLONING AB Peptide YY (PYY) belongs to a family of peptides including neuropeptide Y (NPY) and pancreatic peptide (PP) that regulate numerous functions through both central and peripheral receptors. The solution structure of these peptides is hypothesized to be critically important in receptor selectivity and activation, based on prior demonstration of a stable tertiary conformation of PP called the "PP-fold". Circular dichroism (CD) spectra show a pH-dependent structural transition in the pH range 3-4. Thus we describe the tertiary structure of porcine PYY in water at pH 5.5, 25 degrees C, and 150 mM NaCl, as determined from 2D H-1 NMR data recorded at 500 MHz. A constraint set consisting of 396 interproton distances from NOE data was used as input for distance geometry, simulated annealing, and restrained energy minimization calculations in X-PLOR. The RMSDs of the 20 X-PLOR-generated structures were 0.71 +/- 0.14 and 1.16 +/- 0.17 Angstrom, respectively, for backbone and heavy atom overlays of residues 1-34. The resulting structure consists of two C-terminal helical segments from residues 17 to 22 and 25 to 33 separated by a kink at residues 23, 24, and 25, a turn centered around residues 12-14, and the N-terminus folded near residues 30 and 31. The well-defined portions of the PYY structure reported here bear a marked similarity to the structure of PP. Our findings strongly support the importance of the stable folded structure of this family of peptides for binding and activation of Y receptor subtypes. C1 Univ Calif Los Angeles, CURE, Digest Dis Res Ctr, Greater Los Angles Vet Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Div Digest Dis, Los Angeles, CA 90023 USA. City Hope Natl Med Ctr, Beckman Res Inst, Div Immunol, Duarte, CA 91010 USA. RP Keire, DA (reprint author), Univ Calif Los Angeles, CURE, Digest Dis Res Ctr, Greater Los Angles Vet Hlth Care Syst, Bldg 115,Room 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK41301, DK-33850] NR 42 TC 33 Z9 35 U1 2 U2 5 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0006-2960 J9 BIOCHEMISTRY-US JI Biochemistry PD AUG 15 PY 2000 VL 39 IS 32 BP 9935 EP 9942 DI 10.1021/bi992576a PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 345VK UT WOS:000088835700036 PM 10933813 ER PT J AU Poorkaj, P Peterson, KR Schellenberg, GD AF Poorkaj, P Peterson, KR Schellenberg, GD TI Single-step conversion of P1 and P1 artificial chromosome clones into yeast artificial chromosomes SO GENOMICS LA English DT Article ID TRANSGENIC MICE; HOMOLOGOUS RECOMBINATION; APOLIPOPROTEIN-B; MAMMALIAN-CELLS; DNA FRAGMENTS; YAC DNA; GENE; CLONING; VECTOR; EXPRESSION AB Large insert genomic clones are useful for generating transgenic animals, particularly when specific mutations are introduced. To facilitate manipulation of large genomic sequences, we developed a method of converting Escherichia coli P1 artificial chromosomes (PACs) into yeast artificial chromosomes (YACs). A shuttle vector, pMAX-121, was generated that contains elements needed to generate a YAC (cen4 ars, ura3, his, and two telomere segments) along with similar to 1.3 kb of sequence homologous to P1 and PAC vector sequences. Cotransformation of yeast with the target PAC or P1 clone and pMAX-121 results in two homologous recombination events. The first, between the target clone and pMAX-121, results in a circular molecule. The second is an intramolecular recombination event between the two pMAX-121 telomere sequences, resulting in a linear molecule. The resulting YAC is stably maintained in yeast and can be further modified, using homologous recombination. The method was used to convert a 201-kb PAC containing the human tau gene into a stable linear YAC. A second vector, pLys2-neo, was developed to retrofit the YAC with the yeast lys2 gene, a selectable marker replacing the yeast ura3 gene, and a Pgk-neo cassette that confers G418 resistance to mammalian cells. The resulting YAC can be used for generating transgenic animals and stably transfected cell lines. Also, the lys2 marker facilitates introduction of mutations by homologous recombination. (C) 2000 Academic Press. C1 Vet Affairs Puget Sound Hlth Care Syst, GRECC 182B, Seattle Div, Seattle, WA 98108 USA. Univ Washington, Dept Med, Div Gerontol & Geriatr Med, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Pharmacol, Seattle, WA 98195 USA. Univ Kansas, Med Ctr, Dept Biochem & Mol Biol, Sch Med, Kansas City, KS 66160 USA. RP Poorkaj, P (reprint author), Vet Affairs Puget Sound Hlth Care Syst, GRECC 182B, Seattle Div, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIA NIH HHS [P0AG17586, R01AG11762, AG05136] NR 19 TC 4 Z9 4 U1 1 U2 1 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0888-7543 J9 GENOMICS JI Genomics PD AUG 15 PY 2000 VL 68 IS 1 BP 106 EP 110 DI 10.1006/geno.2000.6267 PG 5 WC Biotechnology & Applied Microbiology; Genetics & Heredity SC Biotechnology & Applied Microbiology; Genetics & Heredity GA 349EM UT WOS:000089030700015 PM 10950935 ER PT J AU Mazarati, AM Hohmann, JG Bacon, A Liu, H Sankar, R Steiner, RA Wynick, D Wasterlain, CG AF Mazarati, AM Hohmann, JG Bacon, A Liu, H Sankar, R Steiner, RA Wynick, D Wasterlain, CG TI Modulation of hippocampal excitability and seizures by galanin SO JOURNAL OF NEUROSCIENCE LA English DT Article DE galanin; transgenic mice; seizures; hippocampus; long-term potentiation; glutamate ID TEMPORAL-LOBE EPILEPSY; CENTRAL-NERVOUS-SYSTEM; SUSTAINING STATUS EPILEPTICUS; LONG-TERM POTENTIATION; ELECTRICAL-STIMULATION; RAT HIPPOCAMPUS; NEUROPEPTIDE-Y; PERFORANT PATH; RELEASE; NEURONS AB Previous studies have shown that the expression of the neuropeptide galanin in the hippocampus is altered by seizures and that exogenous administration of galanin into the hippocampus attenuates seizure severity. To address the role of endogenous galanin in modulation of hippocampal excitability and its possible role in seizure mechanisms, we studied two types of transgenic mice: mice with a targeted disruption of the galanin gene (GalKO) and mice that overexpress the galanin gene under a dopamine-beta-hydroxylase promoter (GalOE). GalKO mice showed increased propensity to develop status epilepticus after perforant path stimulation or systemic kainic acid, as well as greater severity of pentylenetetrazol-induced convulsions. By contrast, GalOE mice had increased resistance to seizure induction in all three models. Physiological tests of hippocampal excitability revealed enhanced perforant path-dentate gyrus long-term potentiation (LTP) in GalKO and reduced LTP in GalOE. GalKO showed increased duration of afterdischarge (AD) evoked from the dentate gyrus by perforant path simulation, whereas GalOE had increased threshold for AD induction. Depolarization-induced glutamate release from hippocampal slices was greater in GalKO and lower in GalOE, suggesting that alterations of physiological and seizure responses in galanin transgenic animals may be mediated through modulation of glutamate release. Our data provide further evidence that hippocampal galanin acts as an endogenous anticonvulsant and suggest that genetically induced changes in galanin expression modulate both hippocampal excitability and predisposition to epileptic seizures. C1 Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Pediat, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. Dept Vet Affairs, Greater Los Angeles Healthcare Syst, Epilepsy Res Labs, Sepulveda, CA 91343 USA. Univ Bristol, Dept Med, Bristol BS2 8HW, Avon, England. Univ Washington, Neurobiol & Behav Program, Seattle, WA 98195 USA. Univ Washington, Dept Obstet & Gynecol, Seattle, WA 98195 USA. Univ Washington, Dept Physiol & Biophys, Seattle, WA 98195 USA. RP Mazarati, AM (reprint author), Univ Calif Los Angeles, Sch Med, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Neurol, 111N1 Epilepsy Res,16111 Plummer St, Sepulveda, CA 91343 USA. FU NICHD NIH HHS [R01-HD27142, U54-HD12626]; NINDS NIH HHS [NS01792] NR 47 TC 152 Z9 156 U1 0 U2 4 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD AUG 15 PY 2000 VL 20 IS 16 BP 6276 EP 6281 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 342ZC UT WOS:000088676400045 PM 10934278 ER PT J AU Green, MJ Farber, NJ Ubel, PA Mauger, DT Aboff, BM Sosman, JM Arnold, RM AF Green, MJ Farber, NJ Ubel, PA Mauger, DT Aboff, BM Sosman, JM Arnold, RM TI Lying to each other - When internal medicine residents use deception with tumor colleagues SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 22nd Annual Meeting of the Society-of-General-Internal-Medicine CY APR 29-MAY 01, 1999 CL SAN FRANCISCO, CALIFORNIA SP Soc Gen Internal Med ID PHYSICIANS ATTITUDES; MISREPRESENTATION; APPLICANTS; STUDENTS; SCHOOL; ETHICS; TRUTH; DISCLOSURE; PATIENT; FRAUD AB Background: While lying is morally problematic, physicians have been known to use deception with their patients and with third parties. Little is known, however, about the use of deception between physicians. Objectives: To determine the likelihood that resident physicians say they would deceive other physicians in various circumstances and to examine how variations in circumstances affect the likelihood of using deception. Method: Two versions of a confidential survey using vignettes were randomly distributed to all internal medicine residents at 4 teaching hospitals in 1998. Survey versions differed by introducing slight variations to each vignette in ways we hypothesized would influence respondents' willingness to deceive. The likelihood that residents say they would use deception in response to each vignette was compared between versions. Results: Three hundred thirty surveys were distributed (response rate, 67%). Of those who responded, 36% indicated they were likely to use deception to avoid exchanging call, 15% would misrepresent a diagnosis in a medical record to protect patient privacy, 14% would fabricate a laboratory value to an attending physician, 6% would substitute their own urine in a drug test to protect a colleague, and 5% would lie about checking a patient's stool for blood to cover up a medical mistake. For some of the scenarios, the likelihood of deceiving was influenced by variations in the vignettes. Conclusions: A substantial percentage of internal medicine residents report they would deceive a colleague in various circumstances, and the likelihood of using deception depends on the context. While lying about clinical issues is not common, it is troubling when it occurs at any time. Medical educators should be aware of circumstances in which residents are likely to deceive, and discuss ways to eliminate incentives to lie. C1 Penn State Univ, Coll Med, Dept Humanities, Hershey, PA 17033 USA. Penn State Univ, Coll Med, Dept Hlth Evaluat Sci, Hershey, PA 17033 USA. Penn State Univ, Milton S Hershey Med Ctr, Gen Internal Med Sect, Hershey, PA 17033 USA. Christiana Care Hlth Syst, Wilmington, DE USA. Vet Affairs Med Ctr, Div Gen Internal Med, Philadelphia, PA USA. Univ Penn, Sch Med, Ctr Bioeth, Philadelphia, PA 19104 USA. Univ Wisconsin, Sch Med, Dept Med, Madison, WI 53706 USA. Univ Pittsburgh, Ctr Bioeth & Hlth Law, Sect Palliat Care & Med Eth, Div Gen Internal Med, Pittsburgh, PA 15260 USA. RP Green, MJ (reprint author), Penn State Univ, Coll Med, Dept Humanities, Campus Box H134,500 Univ Dr, Hershey, PA 17033 USA. NR 39 TC 25 Z9 25 U1 1 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD AUG 14 PY 2000 VL 160 IS 15 BP 2317 EP 2323 DI 10.1001/archinte.160.15.2317 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 343MH UT WOS:000088705800010 PM 10927729 ER PT J AU Chen, M O'Toole, EA Muellenhoff, M Medina, E Kasahara, N Woodley, DT AF Chen, M O'Toole, EA Muellenhoff, M Medina, E Kasahara, N Woodley, DT TI Development and characterization of a recombinant truncated type VII collagen "minigene" - Implication for gene therapy of dystrophic epidermolysis bullosa SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID HUMAN DERMAL FIBROBLASTS; EPIDERMAL GROWTH-FACTOR; COL7A1 UNDERLIE SEVERE; HUMAN KERATINOCYTES; ANCHORING FIBRILS; ACQUISITA ANTIGEN; BURN WOUNDS; IN-VIVO; PROCOLLAGEN; EXPRESSION AB Dystrophic epidermolysis bullosa (DEB) is an inherited mechano-bullous disorder of skin caused by mutations in the type VII collagen gene. The lack of therapy for DEB provides an impetus to develop gene therapy strategies. However, the full-length 9-kilobase type VII collagen cDNA exceeds the cloning capacity of current viral delivery vectors. In this study, we produced a recombinant type VII minicollagen containing the intact noncollagenous domains, NC1 and NC2, and part of the central collagenous domain using stably transfected human 293 cell clones and purified large quantities of the recombinant minicollagen VII from culture media. Minicollagen VII was secreted as correctly-folded, disulfide-bonded, helical trimers resistant to protease degradation. Purified minicollagen VII bound to fibronectin, laminin-5, type I collagen, and type TV collagen. Furthermore, retroviral-mediated transduction of the minigene construct into DEB keratinocytes tin which type VII collagen was absent) resulted in persistent synthesis and secretion of a 230-kDa recombinant minicollagen VII. In comparison with parent DEB keratinocytes, the gene-corrected DEB keratinocytes demonstrated enhanced cell-substratum adhesion, increased proliferative potential, and reduced cell motility, features that reversed the DEB phenotype toward normal. We conclude that the use of the minicollagen VII may provide a strategy to correct the cellular manifestations of gene defects in DEB. C1 Univ So Calif, Dept Med, Div Dermatol, Inst Med Genet, Los Angeles, CA 90033 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90033 USA. RP Woodley, DT (reprint author), Univ So Calif, Dept Med, Div Dermatol, Inst Med Genet, CRL 108,1303 Mission Rd, Los Angeles, CA 90033 USA. FU NIAMS NIH HHS [R01 AR33625] NR 45 TC 42 Z9 42 U1 0 U2 2 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD AUG 11 PY 2000 VL 275 IS 32 BP 24429 EP 24435 DI 10.1074/jbc.M003440200 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 343CC UT WOS:000088683300026 PM 10821839 ER PT J AU Hoffenberg, S Liu, X Nikolova, L Hall, HS Dai, WP Baughn, RE Dickey, BF Barbieri, MA Aballay, A Stahl, PD Knoll, BJ AF Hoffenberg, S Liu, X Nikolova, L Hall, HS Dai, WP Baughn, RE Dickey, BF Barbieri, MA Aballay, A Stahl, PD Knoll, BJ TI A novel membrane-anchored rab5 interacting protein required for homotypic endosome fusion SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID SMALL GTPASE RAB5; GDP DISSOCIATION INHIBITOR; COILED COILS; NUCLEOTIDE EXCHANGE; BINDING PROTEIN; 2-HYBRID SYSTEM; PLASMA-MEMBRANE; CELL-SURFACE; K562 CELLS; TRANSFERRIN AB The ras-related GTPase rab5 is rate-limiting for homotypic early endosome fusion. We used a yeast two-hybrid screen to identify a rab5 interacting protein, rab5ip. The cDNA sequence encodes a ubiquitous 75-kDa protein with an N-terminal transmembrane domain (TM), a central coiled-coil structure, and a C-terminal region homologous to several centrosome-associated proteins. rab5ip lacking the transmembrane domain (rab5ipTM(-)) had a greater affinity in vitro for rab5-guanosine 5'-O-2-(thio)diphosphate than for rab5-guanosine 5'-3-O-(thio)triphosphate. In transfected HeLa cells, rab5ipTM(-) was partly cytosolic and localized (by immunofluorescence) with a rab5 mutant believed to be in a GDP conformation (GFp-rab5(G78A)) but not with GFP-rab5(Q79L), a GTPase-deficient mutant. rab5ip with the transmembrane domain (rab5ipTM(+)) was completely associated with the particulate fraction and localized extensively with GFP-rab5(wt) in punctate endosome-like structures. Overexpression of rab5ipTM(+) using Sindbis virus stimulated the accumulation of fluid-phase horseradish peroxidase by BHK-81 cells, and homotypic endosome fusion in vitro was inhibited by antibody against rab5ip. rab5ipTM(-) inhibited rab5(wt)-stimulated endosome fusion but did not inhibit fusion stimulated by rab5(Q79L). rab5ip represents a novel rab5 interacting protein that may function on endocytic vesicles as a receptor for rab5-GDP and participate in the activation of rab5. C1 Baylor Coll Med, Dept Med, Div Pulm, Houston, TX 77030 USA. Baylor Coll Med, Dept Physiol & Mol Biophys, Houston, TX 77030 USA. Baylor Coll Med, Dept Microbiol & Immunol, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol & Cellular Biol, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Houston, TX 77030 USA. Washington Univ, Sch Med, Dept Cell Biol & Physiol, St Louis, MO 63110 USA. RP Knoll, BJ (reprint author), Univ Houston, Coll Pharm, Dept Pharmcol & Pharmaceut Sci, Bldg SR2,Rm 521D,4800 Calhoun, Houston, TX 77204 USA. RI Stahl, Philip/D-6315-2012; Tang, Amy/L-3226-2016 OI Tang, Amy/0000-0002-5772-2878 NR 57 TC 28 Z9 32 U1 0 U2 3 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD AUG 11 PY 2000 VL 275 IS 32 BP 24661 EP 24669 DI 10.1074/jbc.M909600199 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 343CC UT WOS:000088683300059 PM 10818110 ER PT J AU Minassian, BA Ianzano, L Meloche, M Andermann, E Rouleau, GA Delgado-Escueta, AV Scherer, SW AF Minassian, BA Ianzano, L Meloche, M Andermann, E Rouleau, GA Delgado-Escueta, AV Scherer, SW TI Mutation spectrum and predicted function of laforin in Lafora's progressive myoclonus epilepsy SO NEUROLOGY LA English DT Article ID PROTEIN-TYROSINE PHOSPHATASES; CORPORA-AMYLACEA; BINDING DOMAIN; SPECIFICITY; IMPORT; GENE; FORM AB Background: Lafora's disease is a progressive myoclonus epilepsy with pathognomonic inclusions (polyglucosan bodies) caused by mutations in the EPM2A gene. EPM2A codes for laforin, a protein with unknown function. Mutations have been reported in the last three of the gene's exons, To date, the first exon has not been determined conclusively. It has been predicted based on genomic DNA sequence analysis including comparison with the mouse homologue. Objectives: 1) To detect new mutations in exon 1 and establish the role of this exon in Lafora's disease. 2) To generate hypotheses about the biological function of laforin based on bioinformatic analyses. Methods: 1) PCR conditions and components were refined to allow amplification and sequencing of the first exon of EPM2A. 2) Extensive bioinformatic analyses of the primary structure of laforin were completed. Results: 1) Seven new mutations were identified in the putative exon 1. 2) Laforin is predicted not to localize to the cell membrane or any of the organelles. If contains all components of the catalytic active site of the family of dual-specificity phosphatases. It contains a sequence predicted to encode a carbohydrate binding domain (coded by exon 1) and two putative glucohydrolase catalytic sites. Conclusions: The identification of mutations in exon 1 of EPM2A establishes its role in the pathogenesis of Lafora's disease. The presence of potential carbohydrate binding and cleaving domains suggest a role for laforin in the prevention of accumulation of polyglucosans in healthy neurons. C1 Hosp Sick Children, Dept Genet, Toronto, ON M5G 1X8, Canada. Hosp Sick Children, Dept Paediat, Div Neurol, Toronto, ON M5G 1X8, Canada. Hosp Sick Children, Bioinformat Supercomp Ctr, Toronto, ON M5G 1X8, Canada. Univ Toronto, Toronto, ON M5G 1X8, Canada. Montreal Neurol Inst, Neurogenet Unit, Montreal, PQ, Canada. McGill Univ, Montreal, PQ H3A 2T5, Canada. Montreal Gen Hosp, Res Inst, Ctr Res Neurosci, Montreal, PQ, Canada. Univ Calif Los Angeles, Sch Med, Dept Neurol, Comprehens Epilepsy Program, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90024 USA. W Los Angeles DVA Med Ctr, W Los Angeles, CA USA. RP Scherer, SW (reprint author), Hosp Sick Children, Dept Genet, 555 Univ Ave, Toronto, ON M5G 1X8, Canada. RI Howe, Jennifer/I-9013-2012; Scherer, Stephen /B-3785-2013 OI Scherer, Stephen /0000-0002-8326-1999 NR 27 TC 82 Z9 83 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD AUG 8 PY 2000 VL 55 IS 3 BP 341 EP 346 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 342ED UT WOS:000088631500005 PM 10932264 ER PT J AU Chauncey, TR Gooley, TA Lloid, ME Schubert, MM Lilleby, K Holmberg, L Bensinger, WI AF Chauncey, TR Gooley, TA Lloid, ME Schubert, MM Lilleby, K Holmberg, L Bensinger, WI TI Pilot trial of cytoprotection with amifostine given with high-dose chemotherapy and autologous peripheral blood stem cell transplantation SO AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS LA English DT Article DE amifostine; chemotherapy, high dose; peripheral blood stem cells ID ALLOGENEIC MARROW TRANSPLANTATION; REGIMEN-RELATED TOXICITY; 2 IRRADIATION REGIMENS; BONE-MARROW; RANDOMIZED TRIAL; MYELOID-LEUKEMIA; NITROGEN-MUSTARD; ORAL MUCOSITIS; LUNG-CANCER; PHASE-II AB In an attempt to limit toxicities associated with dose-intensive therapy used for transplant regimens, we performed a pilot study using amifostine with high-dose busulfan (12 mg/kg), melphalan (100 mg/m(2)), and thiotepa (500 mg/m(2)) in 21 patients with a variety of malignancies. After 3 days of oral busulfan, amifostine was given at 910 mg/m(2) IV for 10 minutes, preceding the infusion of each of 2 doses of melphalan and thiotepa given for 4 days. Antiemetic premedication for amifostine was given to all patients. The median patient age was 50 years (range: 32-65 years). Twenty-one patients received 82 separate amifostine infusions. One patient discontinued amifostine after the second dose because of severe nausea and emesis, and two infusions were temporarily held secondary to hypotension. Of these 82 cycles, there was a total of 37 episodes of nausea/vomiting, 28 episodes of sneezing, 11 episodes of flushing, and 1 episode of oral paresthesia. Systolic blood pressure and mean arterial pressure decreased by a mean of 8.4 mm Hg and 5.0 mm Hg, respectively. In general, the infusion was well tolerated. Patients were observed until discharge home (N = 15), until initiation of an additional tandem transplant procedure (N = 4), or until death (N = 2). All twenty-one patients experienced nonhematologic toxicities grade II or greater. Grade II toxicities included mucositis (N = 21), gastrointestinal (N = 3), skin (N = 1), and liver (N = 1), and grade III toxicities included liver (N = 1). Mucositis was also scored according to a detailed toxicity assessment. Mucositis did not appear to be improved with amifostine when compared with a control group of patients not receiving amifostine. Renal dysfunction after transplantation was decreased in the amifostine group, whereas there was no significant effect on posttransplant hepatic dysfunction. Although these data demonstrate the feasibility of delivering parenteral amifostine in conjunction with dose-intensive chemotherapy and autologous peripheral blood stem cell transplantation, there was no evidence of a significant reduction in nonmarrow toxicities. C1 VA Puget Sound Hlth Care Syst, Marrow Transplant Unit, Seattle, WA 98108 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. RP Chauncey, TR (reprint author), VA Puget Sound Hlth Care Syst, Marrow Transplant Unit, S-111-MTU,1660 S Columbian Way, Seattle, WA 98108 USA. FU NCI NIH HHS [CA-47748, CA-15704] NR 44 TC 15 Z9 18 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0277-3732 J9 AM J CLIN ONCOL-CANC JI Am. J. Clin. Oncol.-Cancer Clin. Trials PD AUG PY 2000 VL 23 IS 4 BP 406 EP 411 DI 10.1097/00000421-200008000-00019 PG 6 WC Oncology SC Oncology GA 342BM UT WOS:000088625400019 PM 10955873 ER PT J AU Rosen, HR Gretch, D Kaufman, E Quan, S AF Rosen, HR Gretch, D Kaufman, E Quan, S TI Humoral immune response to hepatitis C after liver transplantation: Assessment of a new recombinant immunoblot assay SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID POLYMERASE CHAIN-REACTION; VIRUS-INFECTION; MAJOR GENOTYPES; ANTIBODIES; IDENTIFICATION; SEQUENCES; DIAGNOSIS; SUBTYPES; PROTEINS; VIREMIA AB OBJECTIVE: The immune control of infection with hepatitis C virus (HCV) is poorly understood; vigorous antibody responses to viral proteins seem to coexist with the virus and thus whether they are neutralizing remains controversial. HCV-related liver failure is the leading indication for orthotopic liver transplantation (OLT) worldwide. Attenuated antibody responses in immunosuppressed patients and decreased reliability compared to assessment of HCV RNA has hampered the use of antibody testing post-OLT. The goals of this current analysis were twofold: to determine the sensitivity of a prototype strip immunoblot assay (RIBA 3.0, Chiron Diagnostics) for the diagnosis of HCV post-OLT; to determine if there was a correlation between antibody response and severity of histological recurrence. METHODS: The study was comprised of 76 HCV-positive individuals divided into three patient groups: liver allograft recipients with evidence of mild or no histological recurrence (n = 52), liver allograft recipients with evidence of severe HCV recurrence and allograft cirrhosis (n = 12), and nontransplant patients being enrolled in an induction interferon trial (n = 12). All transplant patients had histological follow-up of at least 1 yr. RESULTS: Sixty of the 64 (94%) HCV-positive OLT recipients had ii reactivity to two or more recombinant antigens; three of the patients who lacked a detectable response had minimal histological recurrence and one had severe recurrence. All nontransplant patients demonstrated 4+ reactivity to at least two antigens, and 55/64 (86%) OLT recipients demonstrated this same level of reactivity. Seven of the nine patients lacking this high level of reactivity had evidence of minimal recurrence. Furthermore, the mean (+/- SEM) level of antibody reactivity for c100 (p = 0.04) and NS5 (p = 0.01) were significantly tower for patients with mild recurrence after OLT, compared to the other groups. The level of antibody reactivity was unrelated to HCV genotype or viral load. CONCLUSIONS: The recently developed RIBA 3.0 assay for detection of antibodies to HCV appears to be highly sensitive for the diagnosis of HCV post-OLT. In general, the level of antibody reactivity was comparable in the transplant patients and in nonimmunosuppressed controls. The pathogenic implications of the relatively diminished humoral response in patients with mild recurrence post-OLT are discussed. (C) 2000 by Am. Cell. of Gastroenterology. C1 Oregon Hlth Sci Univ, Div Gastroenterol Hepatol, Portland Vet Affairs Med Ctr, Portland, OR 97207 USA. Univ Washington, Div Virol, Seattle, WA 98195 USA. Chiron Diagnost, Emeryville, CA USA. RP Rosen, HR (reprint author), Oregon Hlth Sci Univ, Div Gastroenterol Hepatol, Portland Vet Affairs Med Ctr, OHSU 3710 SW US Vet Hosp Rd,POB 1034,P3-G1, Portland, OR 97207 USA. NR 26 TC 4 Z9 4 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD AUG PY 2000 VL 95 IS 8 BP 2035 EP 2039 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 343KN UT WOS:000088701700031 PM 10950054 ER PT J AU Morgan, RO Virnig, BA DeVito, CA Persily, NA AF Morgan, RO Virnig, BA DeVito, CA Persily, NA TI Medicare HMO disenrollment and selective use of medical care: Osteoarthritis-related joint replacement SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID UNITED-STATES; SERVICES; BENEFICIARIES; HIP AB Objective: Recent Medicare health maintenance organization (HMO) disenrollees use a high level of medical services. This study examined admissions for total hip arthroplasty (THA) and osteoarthritis-related knee replacements (OKR) among Medicare HMO disenrollees and continuously enrolled fee-for-service (FFS) beneficiaries to determine whether Medicare beneficiaries are returning to the FFS system to receive quality-of-life enhancing elective care. Study Design: Retrospective analysis of Medicare inpatient claims for elderly Medicare beneficiaries residing in South Florida between 1990 and 1993. Methods: Inpatient admission rates for THA, OKR, and for 2 acute conditions-total hip replacements related to fracture of the hip (HRF) and acute myocardial infarction (AMI)-were estimated for Medicare HMO disenrollees over the 3-month period immediately following their disenrollment, These rates were compared with standardized rates for Medicare FFS enrollees. Results: The annualized adjusted rates of both THA and OKR were 3.5 to 4 times higher among Medicare HMO disenrollees than among FFS beneficiaries (P less than or equal to .0001 for both procedures); substantially smaller differences were noted for HRF (P less than or equal to .05), and no difference was present for AMI. HMO disenrollees and FFS enrollees did not differ in their levels of comorbidity at the time of admission. Conclusions: These data provide indirect evidence that Medicare HMOs in South Florida are rationing THA and OKR and that beneficiaries respond by returning to the FFS system to seek care. This apparent rationing has important implications regarding for the management of serious, but nonemergent, medical conditions within the evolving Medicare system. C1 VA Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Div Hlth Serv Res, Houston, TX 77030 USA. Univ Minnesota, Sch Publ Hlth, Minneapolis, MN USA. Miami Dept VA Med Ctr, Hlth Serv Res & Dev Ctr, Miami, FL USA. Ctr Geriatr Res Educ & Clin, Miami, FL USA. Univ Miami, Sch Med, Dept Psychiat & Behav Sci, Miami, FL 33152 USA. George Washington Univ, Sch Publ Hlth & Hlth Serv, Washington, DC 20037 USA. RP Morgan, RO (reprint author), VA Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. RI Morgan, Robert/A-8577-2009 NR 24 TC 6 Z9 6 U1 0 U2 0 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD AUG PY 2000 VL 6 IS 8 BP 917 EP 923 PG 7 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 345FF UT WOS:000088804200004 PM 11186503 ER PT J AU Ray, J Berkwits, M Davidoff, F AF Ray, J Berkwits, M Davidoff, F TI The fate of manuscripts rejected by a general medical journal SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID IMPACT FACTOR; PUBLISH AB PURPOSE: The fate of research manuscripts that have been rejected by medical journals is of interest to authors, editors, and peer reviewers, but previous studies were conducted before the widespread availability of computerized literature searches. We update the previous investigations of the fate of rejected research manuscripts by using an electronic literature search and a larger sample, a longer follow-up, and more descriptive journal indexes. METHODS: Using a retrospective cohort study design, we examined 350 manuscripts rejected by the Annals of Internal Medicine, a general medical journal, during 1993 and 1994. We assessed the number of manuscripts that were published after initial rejection, time to eventual publication, journal type (general versus specialty), and journal impact factor (higher scores indicated greater impact) and immediacy index. RESULTS: Of 350 rejected manuscripts, 240 (69%, 95% confidence interval [CI]: 64% to 73%) were eventually published after a mean of 552 days (95% CI: 479 to 544 days, range 121 to 1,792 days). Of 226 rejected research articles and reviews, 159 (70%, 95% CI: 64% to 76%) were subsequently published in specialty journals. During 1993 and 1994, the mean impact factor for articles published in the Annals was 9.60 (95% CI: 9.56 to 9.64), compared with a mean of 3.09 (95% CI: 2.80 to 3.37) for the journals in which the rejected articles were subsequently published (mean difference 6.52, 95% CI: 6.24 to 6.81, P < 0.0001). The immediacy index was also lower for these journals. Time to publication had a weak negative correlation with the impact factor of the journal in which the article was published (correlation coefficient -0.15, P = 0.007). CONCLUSIONS: The majority of the manuscripts that were rejected from a large general medical journal were eventually published after an average of 18 months. Most were published in specialty journals with lower impact factor and immediacy index ratings. Am J Med. 2000;109:131-135. (C) 2000 by Excerpta Medica, Inc. C1 Annals Internal Med, Philadelphia, PA USA. McMaster Univ, Dept Med, Hamilton, ON, Canada. McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada. Philadelphia VA Med Ctr, Philadelphia, PA USA. Univ Penn, Med Ctr, Div Gen Internal Med, Philadelphia, PA 19104 USA. RP Ray, J (reprint author), 133 Shelborne Ave, Toronto, ON M6B 2M8, Canada. NR 20 TC 44 Z9 45 U1 0 U2 4 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD AUG 1 PY 2000 VL 109 IS 2 BP 131 EP 135 DI 10.1016/S0002-9343(00)00450-2 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 347HP UT WOS:000088922800007 PM 10967154 ER PT J AU Akiba, Y Guth, PH Engel, E Nastaskin, I Kaunitz, JD AF Akiba, Y Guth, PH Engel, E Nastaskin, I Kaunitz, JD TI Dynamic regulation of mucus gel thickness in rat duodenum SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE fluorescent microspheres; perfusate glycoprotein concentration; indomethacin; periodic acid/Schiff staining; Alcian blue staining; Brunner's glands ID BRUNNERS GLAND SECRETION; INTESTINAL GOBLET CELLS; LUMINAL ACID; MUCIN SECRETION; NITRIC-OXIDE; SURFACE; GLYCOPROTEINS; PENTAGASTRIN; STIMULATION; MUCOSA AB We examined the dynamic regulation of mucus gel thickness (MGT) in vivo in rat duodenum in response to luminal acid, cyclooxygenase (COX) inhibition, and exogenous PGE(2). An in vivo microscopic technique was used to measure MGT with fluorescent microspheres in urethan-anesthetized rats. Duodenal mucosa was topically superfused with pH 7.0 or pH 2.2 solutions with or without PGE(2) and indomethacin treatments. Glycoprotein concentration of duodenal loop perfusates was measured with periodic acid/Schiff (PAS) or Alcian blue (AB) staining. MGT and perfusate glycoprotein concentration were stable during a 35-min perfusion with pH 7.0 solution. Acid exposure increased MGT and PAS- and AB-positive perfusate glycoprotein concentrations. Indomethacin pretreatment increased both PAS- and AB-positive perfusate glycoprotein at baseline; subsequent acid superfusion decreased perfusate glycoproteins and gel thickness. PGE(2) (1 mg/kg iv) simultaneously increased MGT and PAS-positive perfusate glycoprotein concentrations followed by a transient increase in AB-positive glycoprotein concentration, suggesting contributions from goblet cells and Brunner's glands. Parallel changes in MGT and perfusate glycoprotein concentration in response to luminal acid and PGE(2) suggest that rapid MGT variations reflect alterations in the balance between mucus secretion and exudation, which in turn are regulated by a COX-related pathway. Luminal acid and PGE(2) augment mucus secretion from goblet cells and Brunner's glands. C1 Univ Calif Los Angeles, Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Biomath, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Coll Letters & Sci, Los Angeles, CA 90073 USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, Bldg 114,Suite 217,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-54221] NR 48 TC 44 Z9 46 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD AUG PY 2000 VL 279 IS 2 BP G437 EP G447 PG 11 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 338FQ UT WOS:000088408200025 PM 10915654 ER PT J AU Lu, L Gunja-Smith, Z Woessner, JF Ursell, PC Nissen, T Galardy, RE Xu, Y Zhu, PL Schwartz, GG AF Lu, L Gunja-Smith, Z Woessner, JF Ursell, PC Nissen, T Galardy, RE Xu, Y Zhu, PL Schwartz, GG TI Matrix metalloproteinases and collagen ultrastructure in moderate myocardial ischemia and reperfusion in vivo SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE ventricular function; collagenase; gelatinase; scanning electron microscopy; enzyme inhibitors ID DILATED CARDIOMYOPATHY; CONNECTIVE-TISSUE; PLASMINOGEN-ACTIVATOR; EXTRACELLULAR-MATRIX; STUNNED MYOCARDIUM; PORCINE MYOCARDIUM; FIBRILLAR COLLAGEN; RAT MYOCARDIUM; HEART-FAILURE; EXPRESSION AB Severe ischemic injury or infarction of myocardium may cause activation of matrix metalloproteinases (MMPs) and damage the interstitial matrix. However, it is unknown whether MMP activation and matrix damage occur after moderate ischemia and reperfusion that result in myocardial stunning without infarction, and if so whether such changes contribute to postischemic myocardial expansion and contractile dysfunction. To address these questions, open-chest anesthetized pigs underwent 90 min of regional ischemia (subendocardial blood flow 0.4 +/- 0.1 ml . g(-1) . min(-1)) and 90 min of reperfusion. After ischemia plus reperfusion, histological and ultrastructural examination revealed no myocardial infarction or inflammatory cell infiltration. Myocardial MMP-9 content increased threefold with a fourfold increase in the active form (P < 0.001). Myocardial collagenase content doubled (P < 0.01) but remained in latent form. MMP-2 and tissue inhibitors of metalloproteinases were unaffected. Despite increases in MMPs, collagen ultrastructure (assessed by cell maceration scanning electron microscopy) was unaltered. Intracoronary administration of the MMP inhibitor GM-2487 did not prevent or attenuate myocardial expansion (assessed by regional diastolic dimensions at near-zero left ventricular pressure) or contractile dysfunction. We conclude that although moderate ischemia and reperfusion alter myocardial MMP content and activity, these effects do not result in damage to interstitial collagen, nor do they contribute to myocardial expansion or contractile dysfunction. C1 Univ Colorado, Hlth Sci Ctr, Div Cardiol, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Dept Vet Affairs Med Ctr, Cardiol Sect, Denver, CO 80220 USA. Univ Miami, Sch Med, Dept Med, Miami, FL 33101 USA. Univ Miami, Sch Med, Dept Biochem & Mol Biol, Miami, FL 33101 USA. Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Pathol, San Francisco, CA 94143 USA. RP Schwartz, GG (reprint author), Denver VA Med Ctr, Cardiol Sect 111B, 1055 Clermont St, Denver, CO 80220 USA. NR 52 TC 47 Z9 50 U1 1 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD AUG PY 2000 VL 279 IS 2 BP H601 EP H609 PG 9 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 340RQ UT WOS:000088549100019 PM 10924059 ER PT J AU Wexler, HM Molitoris, E Molitoris, D Finegold, SM AF Wexler, HM Molitoris, E Molitoris, D Finegold, SM TI In vitro activity of moxifloxacin against 179 strains of anaerobic bacteria found in pulmonary infections SO ANAEROBE LA English DT Article ID RESPIRATORY-TRACT PATHOGENS; ANTIMICROBIAL AGENTS; BAY-12-8039; 8-METHOXYQUINOLONE; FLUOROQUINOLONE; QUINOLONE AB The activity of moxifloxacin (BAY 12-8039), a new 8-methoxyquinolone, was determined using the NCCLS-approved Wadsworth brucella laked blood agar method and compared to the activities of metronidazole, penicillin G, piperacillin/tazobactam and trovafloxacin. Breakpoints used to define susceptible and resistant categories were, respectively: less than or equal to 8 and greater than or equal to 32 mu g/mL for metronidazole, less than or equal to 2 and greater than or equal to 8 mu g/mL for moxifloxacin and trovafloxacin, less than or equal to 0.5 and greater than or equal to 2 mu g/mL for penicillin G and less than or equal to 32 and greater than or equal to 128 mu g/mL for piperacillin/tazobactam. A total of 179 anaerobic isolates from pulmonary infections were tested. Piperacillin/tazobactam was the most active antimicrobial, inhibiting 99% of strains at the susceptible breakpoint. Ninety-seven percent of these isolates were susceptible to moxifloxacin; 96% to trovafloxacin, 89% to metronidazole and 43% to penicillin G. Geometric mean moxifloxacin MIC values for Bacteroides fragilis and the B. fragilis group were 0.5 and 0.8 mu g/mL, respectively. Eighty-eight percent of B, fragilis and 100% of other B. fragilis group species were susceptible to both moxifloxacin and trovafloxacin. All of the strains of B. fragilis and most of the other B. fragilis group species were resistant to penicillin G. At least 99% of other Bacteroides species, Prevotella, and Fusobacterium strains were susceptible to moxifloxacin, metronidazole, piperacillin/tazobactam and trovafloxacin (88% were susceptible to trovafloxacin at 2 mu g/mL and all were susceptible at 4 mu g/mL). The strains of Clostridium difficile and Clostridium ramosum found in these specimens were both resistant to penicillin G but susceptible to the other agents. All strains of Peptostreptococcus species were susceptible to all of the agents except penicillin G. Activities of the agents against non-spore-forming Gram-positive rods at the intermediate breakpoint were, respectively, moxifloxacin-100%, metronidazole-49%, penicillin G-86%, piperacillin/tazobactam-100%, and trovafloxacin-97%. The promising in vitro activity of moxifloxacin against anaerobic pulmonary isolates warrants further investigation, including clinical correlation studies. C1 Vet Adm Greater Los Angeles Hlth Serv, Med Serv, Los Angeles, CA 90073 USA. Vet Adm Greater Los Angeles Hlth Serv, Res Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Immunol & Microbiol, Los Angeles, CA 90024 USA. RP Wexler, HM (reprint author), VA Wadsworth Med Ctr 691 151J, Microbial Dis Res Lab, Bldg 304,Room E3-224, Los Angeles, CA 90073 USA. NR 18 TC 6 Z9 7 U1 0 U2 0 PU ACADEMIC PRESS LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1075-9964 J9 ANAEROBE JI Anaerobe PD AUG PY 2000 VL 6 IS 4 BP 227 EP 231 DI 10.1006/anae.2000.0348 PG 5 WC Microbiology SC Microbiology GA 343PY UT WOS:000088711800002 ER PT J AU Luterman, JD Haroutunian, V Yemul, S Purohit, D Aisen, PS Mohs, R Pasinetti, GM AF Luterman, JD Haroutunian, V Yemul, S Purohit, D Aisen, PS Mohs, R Pasinetti, GM TI Cytokine gene expression as a function of the clinical progression of Alzheimer disease dementia SO ARCHIVES OF NEUROLOGY LA English DT Article ID GROWTH-FACTOR-BETA; NEUROFIBRILLARY TANGLES; SERUM INTERLEUKIN-6; NEURITIC PLAQUES; BRAIN; TGF-BETA-1; ALPHA(1)-ANTICHYMOTRYPSIN; RESPONSES; ROLES; ALPHA AB Background Inflammatory cytokines have been linked to Alzheimer disease (AD) neurodegeneration, but little is known about the temporal control of their expression in relationship to clinical measurements of AD dementia progression. Design and Main Outcome Measures: We measured inflammatory cytokine messenger RNA (mRNA) expression in postmortem brain specimens of elderly subjects at different clinical stages of dementia and neuropathological dysfunction. Setting and Patients: Postmortem study of nursing home patients. Results: In brains of cognitively normal control subjects, higher interleukin 6 (IL-6) and transforming growth factor beta 1 (TGF-beta 1) mRNA expression was observed in the entorhinal cortex and superior temporal gyrus compared with the occipital cortex. Compared with age-matched controls, subjects with severe/terminal dementia, but not subjects at earlier disease stages, had higher IL-6 and TGF-beta 1 mRNA expression in the entorhinal cortex (P<.01) and superior temporal gyrus (P<.01). When stratified by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropathological criteria, IL-6 mRNA expression in both the entorhinal cortex (P<.05) and superior temporal gyrus (P<.01) correlated with the level of neurofibrillary tangles but not neuritic plaques. However, in the entorhinal cortex, TGF-beta 1 mRNA did not correlate with the level of either neurofibrillary tangles or neuritic plaques. Interestingly, in the superior temporal gyrus, TGF-beta 1 mRNA expression negatively correlated with neurofibrillary tangles (P<.01) and showed no relationship to the pathological features of neuritic plaques. Conclusions: The data are consistent with the hypothesis that cytokine expression may differentially contribute to the vulnerability of independent cortical regions during the clinical progression of AD and suggest that an inflammatory cytokine response to the pathological effects of AD does not occur until the late stages of the disease. These findings have implications for the design of anti-inflammatory treatment strategies. C1 Mt Sinai Med Ctr, Neuroinflammat Res Labs, Dept Psychiat, New York, NY 10029 USA. Mt Sinai Sch Med, Dept Pathol, New York, NY 10029 USA. Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Dept Psychiat, Bronx, NY USA. Georgetown Univ, Sch Med, Dept Neurol, Washington, DC USA. RP Pasinetti, GM (reprint author), Mt Sinai Med Ctr, Neuroinflammat Res Labs, Dept Psychiat, Box 1229,1 Gustave L Levy Pl, New York, NY 10029 USA. FU NIA NIH HHS [AG13799, AG14329, AG16743] NR 25 TC 119 Z9 126 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD AUG PY 2000 VL 57 IS 8 BP 1153 EP 1160 DI 10.1001/archneur.57.8.1153 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 342PR UT WOS:000088654800008 PM 10927795 ER PT J AU Ehde, DM Czerniecki, JM Smith, DG Campbell, KM Edwards, WT Jensen, MP Robinson, LR AF Ehde, DM Czerniecki, JM Smith, DG Campbell, KM Edwards, WT Jensen, MP Robinson, LR TI Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE amputation; chronic pain; phantom limb pain; stump pain; sensation; leg; rehabilitation ID STUMP PAIN; AMPUTEES; QUESTIONNAIRE AB Objectives: To determine the characteristics of phantom limb sensation, phantom limb pain, and residual limb pain, and to evaluate pain-related disability associated with phantom limb pain. Design: Retrospective, cross-sectional survey. Six or more months after lower limb amputation, participants (n = 255) completed an amputation pain questionnaire that included several standardized pain measures. Setting: Community-based survey from clinical databases. Participants: A community-based sample of persons with lower limb amputations. Main Outcome Measures: Frequency, duration, intensity, and quality of phantom limb and residual limb pain, and pain-related disability as measured by the Chronic Pain Grade. Results: Of the respondents, 79% reported phantom limb sensations, 72% reported phantom limb pain, and 74% reported residual limb pain. Many described their phantom limb and residual limb pain as episodic and not particularly bothersome. Most participants with phantom limb pain were classified into the two low pain-related disability categories: grade I, low disability/low pain intensity (47%) or grade Il, low disability/high pain intensity (28%). Many participants reported having pain in other anatomic locations, including the back (52%). Conclusions: Phantom limb and residual limb pain are common after a lower limb amputation. For most, the pain is episodic and not particularly disabling. However, for a notable subset, the pain may be quite disabling. Pain after amputation should be viewed from a broad perspective that considers other anatomic sites as well as the impact of pain on functioning. C1 Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98104 USA. Univ Washington, Dept Orthopaed Surg, Seattle, WA 98104 USA. Univ Washington, Dept Anesthesiol, Seattle, WA 98104 USA. Harborview Med Ctr, VA Puget Sound Hlth Care Syst, Seattle, WA USA. VA Ctr Amputat Prosthet & Limb Loss Prevent, Seattle, WA USA. RP Ehde, DM (reprint author), Univ Washington, Sch Med, Dept Rehabil Med, 325 9th Ave,Box 359740, Seattle, WA 98104 USA. RI Robinson , Lawrence/D-8455-2013 FU NICHD NIH HHS [P01 HD/NS33988] NR 22 TC 165 Z9 168 U1 2 U2 12 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD AUG PY 2000 VL 81 IS 8 BP 1039 EP 1044 DI 10.1053/apmr.2000.7583 PG 6 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 349JJ UT WOS:000089041700006 PM 10943752 ER PT J AU Yamamura, MS Gilster, JC Myers, BS Deveney, CW Sheppard, BC AF Yamamura, MS Gilster, JC Myers, BS Deveney, CW Sheppard, BC TI Laparoscopic Heller myotomy and anterior fundoplication for achalasia results in a high degree of patient satisfaction SO ARCHIVES OF SURGERY LA English DT Article; Proceedings Paper CT 71st Annual Session of the Pacific-Coast-Surgical-Association CY FEB 19-22, 2000 CL SAN FRANCISCO, CALIFORNIA SP Pacific Coast Surg Assoc ID BOTULINUM TOXIN INJECTION; ESOPHAGEAL ACHALASIA; GASTROESOPHAGEAL REFLUX; ANTIREFLUX PROCEDURE; ESOPHAGOMYOTOMY; SURGERY; DILATATION; OPERATION; OUTCOMES; EFFICACY AB Hypothesis: Laparoscopic Heller myotomy with anterior fundoplication will alleviate the symptoms of achalasia and result in excellent patient satisfaction. Design: Retrospective study of consecutive patients who underwent laparoscopic Heller myotomy with anterior fundoplication for achalasia between October 1995 and July 1999. A telephone survey assessed symptoms and satisfaction. Patients were asked to quantitate their symptoms on a scale of 0 to 3 (0 = none; 1, mild; 2, moderate; and 3, severe). Setting: University referral center. Patients: Twenty-four patients who underwent laparoscopic Heller myotomy with anterior fundoplication for achalasia. Main Outcome Measures: Postoperative symptoms and satisfaction. Results: Twenty-one patients (88%) were successfully contacted. Mean follow-up was 16.5 months. The laparoscopic approach was successful in all but 3(88%). The mean dysphagia score was 2.81 preoperatively and 0.81 postoperatively (P<.000). The mean chest pain score was 1.57 preoperatively and 0.86 postoperatively (P<.015). The mean supine regurgitation score was 2.10 preoperatively and 0.57 postoperatively (P<.000). The mean upright regurgitation score was 1.57 preoperatively and 0.52 postoperatively (P<.000). The mean heartburn score was 1.57 preoperatively and 0.57 postoperatively (P <.000). Postoperatively, 18 (86%) of 21 patients could swallow bread without difficulty and 17 (89%) of 19 patients could eat meat without difficulty (2 were excluded as they were vegetarians). Twenty (95%) of 21 patients reported improvement after the operation. Conclusions: Laparoscopic Heller myotomy with anterior fundoplication significantly relieves the symptoms of achalasia without causing the symptoms of gastroesophageal reflux disease. This procedure results in excellent overall patient satisfaction. C1 Oregon Hlth Sci Univ, Dept Surg, Portland, OR 97201 USA. Vet Affairs Med Ctr, Portland, OR USA. RP Deveney, CW (reprint author), Portland VA Med Ctr, P8SURG,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. NR 30 TC 29 Z9 33 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD AUG PY 2000 VL 135 IS 8 BP 902 EP 905 DI 10.1001/archsurg.135.8.902 PG 4 WC Surgery SC Surgery GA 342HN UT WOS:000088639300004 PM 10922249 ER PT J AU Pascualy, M Petrie, EC Brodkin, K Peskind, ER Wilkinson, CW Raskind, MA AF Pascualy, M Petrie, EC Brodkin, K Peskind, ER Wilkinson, CW Raskind, MA TI Hypothalamic pituitary adrenocortical and sympathetic nervous system responses to the cold presser test in Alzheimer's disease SO BIOLOGICAL PSYCHIATRY LA English DT Article DE Alzheimer's disease; cortisol; ACTH; norepinephrine; epinephrine; stress ID CORTICOTROPIN-RELEASING HORMONE; DEXAMETHASONE SUPPRESSION TEST; RECEPTOR GENE-EXPRESSION; CA3 PYRAMIDAL NEURONS; CEREBROSPINAL-FLUID; CORTISOL-LEVELS; SENILE DEMENTIA; ADRENAL AXIS; RAT-BRAIN; PLASMA AB Background: Increased basal activity of the hypothalamic-pituitary-adrenocortical (HPA) axis has been repeatedly demonstrated in Alzheimer's disease (AD), and some studies suggest increased basal activity of the sympathetic nervous system (SNS) in this disorder; however, the effects of AD on HPA axis or SNS responses to a standardized aversive stressor have not been examined. The neuroendocrine response to aversive stress may be relevant to the pathophysiology of AD. Methods. Plasma adrenocorticotropic hormone (ACTH), cortisol, norepinephrine (NE), and epinephrine responses to a 1-min cold pressor test (CPT)were measured in nine medically healthy AD outpatients (age 76 +/- 1 years) and nine age- and gender-matched medically healthy cognitively normal older subjects (age 76 +/- 1 year). Results: The cortisol response to CPT was increased in the AD group but the ACTH response did not differ between groups. Basal NE responses to CPT did not differ between groups, the blood pressure response to CPT was higher in the AD subjects. Conclusions: These results suggest increased HPA axis responsiveness to CPT at the level of the adrenal cortex in AD. The results also suggest increased basal sympathoneural activity and increased cardiovascular responsiveness to sympathoneural stimulation in AD under the conditions of this experimental protocol. Increased SNS stimulatory modulation of the adrenal cortex is a possible mechanism contributing to the observed enhanced cortisol response to CPT in these AD subjects. Biol Psychiatry 2000;48:247-254 (C) 2000 Society of Biological Psychiatry. C1 VA Puget Sound Hlth Care Syst, Mental Hlth Serv S116, Educ & Clin Ctr, NW Mental Illness Res, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Raskind, MA (reprint author), VA Puget Sound Hlth Care Syst, Mental Hlth Serv S116, Educ & Clin Ctr, NW Mental Illness Res, 1660 S Columbian Way, Seattle, WA 98108 USA. FU NIA NIH HHS [AG05136, AG08419] NR 61 TC 39 Z9 39 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD AUG 1 PY 2000 VL 48 IS 3 BP 247 EP 254 DI 10.1016/S0006-3223(00)00879-9 PG 8 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 338VK UT WOS:000088443800008 PM 10924668 ER PT J AU Schatten, H Wiedemeier, AMD Taylor, M Lubahn, DB Greenberg, NM Besch-Williford, C Rosenfeld, CS Day, JK Ripple, M AF Schatten, H Wiedemeier, AMD Taylor, M Lubahn, DB Greenberg, NM Besch-Williford, C Rosenfeld, CS Day, JK Ripple, M TI Centrosome-centriole abnormalities are markers for abnormal cell divisions and cancer in the transgenic adenocarcinoma mouse prostate (TRAMP) model SO BIOLOGY OF THE CELL LA English DT Article DE cell proliferation; centrosomes; apoptosis; cytoskeleton; prostate cancer ID SEA-URCHIN EGGS; MICROTUBULE ORGANIZING CENTERS; MONOCLONAL-ANTIBODY; CYCLE; ANEUPLOIDY; PROTEIN; GENE; INSTABILITY; EXPRESSION; DIAZEPAM AB We utilized the transgenic adenocarcinoma mouse prostate (TRAMP) model to study the formation of abnormal mitosis in malignant tumors of the prostate. The results presented here are focused on centrosome and centriole abnormalities and the implications for abnormal cell divisions, genomic instability, and apoptosis. Centrosomes are microtubule organizing organelles which assemble bipolar spindles in normal cells but can organize mono-, tri-, and multipolar mitoses in tumor cells, as shown here with histology and electron microscopy in TRAMP neoplastic tissue. These abnormalities will cause unequal distribution of chromosomes and can initiate imbalanced cell cycles in which checkpoints for cell cycle control are lost. Neoplastic tissue of the TRAMP model is also characterized by numerous apoptotic cells. This may be the result of multipolar mitoses related to aberrant centrosome formations. Our results also reveal that centrosomes at the poles in mitotic cancer cells contain more than the regular perpendicular pair of centrioles which indicates abnormal distribution of centrioles during separation to the mitotic poles. Abnormalities in the centriole-centrosome complex are also seen during interphase where the complex is either closely associated with the nucleus or loosely dispersed in the cytoplasm. An increase in centriole numbers is observed during interphase, which may be the result of increased centriole duplication. Alternatively, these centrioles may be derived from basal bodies that have accumulated. in the cell's cytoplasm, after the loss of cell borders. The supernumerary centrioles may participate in the formation of abnormal mitoses during cell division. These results demonstrate multiple abnormalities in the centrosome-centriole complex during prostate cancer that result in abnormal mitoses and may lead to increases in genomic instability and/or apoptosis. (C) 2000 Editions scientifiques et medicales Elsevier SAS. C1 Univ Missouri, Dept Vet Pathobiol, Columbia, MO 65211 USA. Univ Missouri, Canc Res Ctr, Columbia, MO 65211 USA. Univ Missouri, Dept Biochem & Child Hlth, Columbia, MO 65211 USA. Univ Missouri, Genet Area Program, Columbia, MO 65211 USA. Baylor Coll Med, Dept Cell Biol, Houston, TX 77030 USA. Baylor Coll Med, Scott Dept Urol, Houston, TX 77030 USA. Univ Missouri, Dept Anim Sci, Columbia, MO 65211 USA. Univ Wisconsin, Dept Med, Inst Aging, Madison, WI 53792 USA. Univ Wisconsin, Dept Med, Ctr Comprehens Canc, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Hosp, Madison, WI 53792 USA. RP Schatten, H (reprint author), Univ Missouri, Dept Vet Pathobiol, 1600 E Rollins St, Columbia, MO 65211 USA. NR 40 TC 28 Z9 28 U1 0 U2 2 PU EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER PI PARIS CEDEX 15 PA 23 RUE LINOIS, 75724 PARIS CEDEX 15, FRANCE SN 0248-4900 J9 BIOL CELL JI Biol. Cell PD AUG PY 2000 VL 92 IS 5 BP 331 EP 340 DI 10.1016/S0248-4900(00)01079-0 PG 10 WC Cell Biology SC Cell Biology GA 370AY UT WOS:000165101000003 PM 11071042 ER PT J AU Heinrich, MC Griffith, DJ Druker, BJ Wait, CL Ott, KA Zigler, AJ AF Heinrich, MC Griffith, DJ Druker, BJ Wait, CL Ott, KA Zigler, AJ TI Inhibition of c-kit receptor tyrosine kinase activity by STI 571, a selective tyrosine kinase inhibitor SO BLOOD LA English DT Article ID STEM-CELL FACTOR; GASTROINTESTINAL STROMAL TUMORS; COLONY-STIMULATING FACTOR; BLOOD MONONUCLEAR-CELLS; BONE-MARROW CELLS; WS/WS MUTANT RATS; LUNG-CANCER; GRANULOCYTE-MACROPHAGE; INTERSTITIAL-CELLS; PROTEIN-KINASE AB STI 571 (formerly known as CGP 57148B) is a known inhibitor of the c-abl, bcr-abl, and platelet-derived growth-factor receptor (PDGFR) tyrosine kinases, This compound is being evaluated in clinical trials for the treatment of chronic myelogenous leukemia, We sought to extend the activity profile of STI 571 by testing its ability to inhibit the tyrosine kinase activity of c-kit, a receptor structurally similar to PDGFR, We treated a c-kit expressing a human myeloid leukemia cell line, M-07e, with ST1571 before stimulation with Steel factor (SLF). ST1571 inhibited c-kit auto-phosphorylation, activation of mitogen-activated protein (MAP) kinase, and activation of Akt without altering total protein levels of c-kit, MAP kinase, or Akt, The concentration that produced 50% inhibition for these effects was approximately 100 nmol/L, STI 571 also significantly decreased SLF-dependent growth of M-07e cells in a dose-dependent manner and blocked the antiapoptotic activity of SLF, In contrast, the compound had no effect on MAP kinase activation or cellular proliferation in response to granulocyte-macrophage colony-stimulating factor. We also tested the activity of STI 571 in a human mast cell leukemia cell line (HMC-1), which has an activated mutant form of c-kit, STI 571 had a more potent inhibitory effect on the kinase activity of this mutant receptor than it did on ligand-dependent activation of the wildtype receptor. These findings show that STI 571 selectively inhibits c-kit tyrosine kinase activity and downstream activation of target proteins involved in cellular proliferation and survival. This compound may be useful in treating cancers associated with increased c-kit kinase activity. (C) 2000 by The American Society of Hematology. C1 Oregon Hlth Sci Univ, Dept Med, Div Hematol & Med Oncol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Portland, OR USA. RP Heinrich, MC (reprint author), R&D 19, 3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. NR 77 TC 720 Z9 754 U1 2 U2 22 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD AUG 1 PY 2000 VL 96 IS 3 BP 925 EP 932 PG 8 WC Hematology SC Hematology GA 337ZQ UT WOS:000088394000021 PM 10910906 ER PT J AU Carbo, N Lopez-Soriano, J Costelli, P Busquets, S Alvarez, B Baccino, FM Quinn, LS Lopez-Soriano, FJ Argiles, JM AF Carbo, N. Lopez-Soriano, J. Costelli, P. Busquets, S. Alvarez, B. Baccino, F. M. Quinn, L. S. Lopez-Soriano, F. J. Argiles, J. M. TI Interleukin-15 antagonizes muscle protein waste in tumour-bearing rats SO BRITISH JOURNAL OF CANCER LA English DT Article DE IL-15; cancer cachexia; protein turnover; skeletal muscle; proteasome; ubiquitin AB Tissue protein hypercatabolism (TPH) is an important feature in cancer cachexia, particularly with regard to the skeletal muscle. The Yoshida AH-130 rat ascites hepatoma is a model system for studying the mechanisms involved in the processes that lead to tissue depletion, since it induces in the host a rapid and progressive muscle wasting, primarily due to TPH. The present study was aimed at investigating if IL-15, which is known to favour muscle fibre hypertrophy, could antagonize the enhanced muscle protein breakdown in this cancer cachexia model. Indeed, IL-15 treatment partly inhibited skeletal muscle wasting in AH-130-bearing rats by decreasing (8-fold) protein degradative rates (as measured by C-14-bicarbonate pre-loading of muscle proteins) to values even lower than those observed in non-tumour bearing animals. These alterations in protein breakdown rates were associated with an inhibition of the ATP-ubiquitin-dependent proteolytic pathway (35% and 41% for 2.4 and 1.2 kb ubiquitin mRNA, and 57% for the C8 proteasome subunit, respectively). The cytokine did not modify the plasma levels of corticosterone and insulin in the tumour hosts. The present data give new insights into the mechanisms by which IL-15 exerts its preventive effect on muscle protein wasting and seem to warrant the implementation of experimental protocols involving the use of the cytokine in the treatment of pathological states characterized by TPH, particularly in skeletal muscle, such as in the present model of cancer cachexia. (C) 2000 Cancer Research Campaign C1 [Carbo, N.; Lopez-Soriano, J.; Busquets, S.; Alvarez, B.; Lopez-Soriano, F. J.; Argiles, J. M.] Univ Barcelona, Fac Biol, Dept Bioquim & Biol Mol, Diagonal 645, E-08071 Barcelona, Spain. [Costelli, P.; Baccino, F. M.] Univ Turin, Dipartimento Med & Oncol Sperimentale, Turin, Italy. [Baccino, F. M.] Ctr CNR Immunogenet & Oncol Sperimentale, Turin, Italy. [Quinn, L. S.] VA Puget Sound Hlth Care Syst, Amer Lake Div, Geriatr Res Educ & Clin Ctr, Tacoma, WA 98493 USA. RP Argiles, JM (reprint author), Univ Barcelona, Fac Biol, Dept Bioquim & Biol Mol, Diagonal 645, E-08071 Barcelona, Spain. OI Busquets, Silvia/0000-0002-9319-3555 FU Fondo de Investigaciones Sanitarias de la Seguridad Social of the Spanish Health Ministry [97/2059]; Direccion General de Investigacion Cientifica y Tecnica from the Spanish Ministry of Education and Science [PB94-0938, HI-1996-0049]; Ministero dell'Universita e della Ricerca Scientifica e Tecnologica, Roma; Consiglio Nazionale delle Ricerche (Special Project ACRO), Roma; Associazione Italiana per la Ricerca sul Cancro, Milano FX Work supported by grants from the Fondo de Investigaciones Sanitarias de la Seguridad Social (97/2059) of the Spanish Health Ministry, the Direccion General de Investigacion Cientifica y Tecnica (PB94-0938 and HI-1996-0049) from the Spanish Ministry of Education and Science, the Ministero dell'Universita e della Ricerca Scientifica e Tecnologica (60% and 40% funds), Roma, the Consiglio Nazionale delle Ricerche (Special Project ACRO), Roma, the Associazione Italiana per la Ricerca sul Cancro, Milano. The authors would like to thank Immunex Corporation (Seattle, WA, USA), which kindly provided IL-15, and Dr MJ Schlesinger and Dr K Tanaka for providing the ubiquitin-specific and proteasome C8 probes, respectively. NR 54 TC 92 Z9 98 U1 0 U2 3 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0007-0920 EI 1532-1827 J9 BRIT J CANCER JI Br. J. Cancer PD AUG PY 2000 VL 83 IS 4 BP 526 EP 531 DI 10.1054/bjoc.2000.1299 PG 6 WC Oncology SC Oncology GA V42ZR UT WOS:000209652200019 PM 10945502 ER PT J AU Ropiquet, F Giri, D Kwabi-Addo, B Mansukhani, A Ittmann, M AF Ropiquet, F Giri, D Kwabi-Addo, B Mansukhani, A Ittmann, M TI Increased expression of fibroblast growth factor 6 in human prostatic intraepithelial neoplasia and prostate cancer SO CANCER RESEARCH LA English DT Article ID HUMAN BREAST-CANCER; FACTOR RECEPTOR-4; EPITHELIAL-CELLS; OVER-EXPRESSION; FGF RECEPTORS; FAMILY; AUTOCRINE; INVASION; LINES AB Fibroblast growth factors (FGFs) are known to play an important role in the growth of normal prostatic epithelial cells. In addition to their effects on proliferation, FGFs can promote cell motility, increase tumor angiogenesis, and inhibit apoptosis, all of which play an important role in tumor progression. To determine whether FGFs are overexpressed in human prostate cancers, we analyzed 26 prostate cancer RNAs by reverse transcription-PCR for expression of FGF3, FGF4, and FGF6, which cannot be detected in normal prostate tissue by this technique. Fourteen of 26 prostate cancers expressed FGF6 mRNA. No expression of FGF3 or FGF4 was detected. An ELISA of tissue extracts of normal prostate, high-grade prostatic intraepithelial neoplasia (PIN), and prostate cancer for FGF6 showed that this growth factor was undetectable in normal prostate but was present at elevated levels in 4 of 9 PIN lesions and in 15 of 24 prostate cancers. Immunohistochemical analysis with anti-FGF6 antibody revealed weak staining of prostatic basal cells in normal prostate that was markedly elevated in PIN. In the prostate cancers, the majority of cases revealed expression of FGF6 by the prostate cancer cells themselves. In two cases, expression was present in prostatic stromal cells. Exogenous FGF6 was able to stimulate proliferation of primary prostatic epithelial and stromal cells, immortalized prostatic epithelial cells, and prostate cancer cell lines in tissue culture. FGF receptor 4, which is the most potent FGF receptor for FGF6, is expressed in the human prostate in vivo and in all of the cultured cell lines. Thus, FGF6 is increased in PIN and prostate cancer and can promote the proliferation of the transformed prostatic epithelial cells via paracrine and autocrine mechanisms. C1 Houston Vet Affairs Med Ctr, Res Serv, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. NYU, Sch Med, Dept Microbiol, New York, NY 10016 USA. RP Ittmann, M (reprint author), Houston Vet Affairs Med Ctr, Res Serv, 2002 Holcombe Blvd, Houston, TX 77030 USA. RI Kwabi-Addo, Bernard/A-6993-2016 OI Kwabi-Addo, Bernard/0000-0003-3692-6350 NR 31 TC 58 Z9 61 U1 1 U2 1 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD AUG 1 PY 2000 VL 60 IS 15 BP 4245 EP 4250 PG 6 WC Oncology SC Oncology GA 342BQ UT WOS:000088625700043 PM 10945637 ER PT J AU Payne, TH AF Payne, TH TI Computer decision support systems SO CHEST LA English DT Article DE decision support systems, clinical; drug therapy, computer-assisted; hospital information systems; medical informatics; medical records systems, computerized; practice guidelines; therapy, computer-assisted ID PHYSICIAN ORDER ENTRY; MEDICAL RECORD; GUIDELINES; PERFORMANCE; MANAGEMENT; INFORMATION; ERRORS; CARE AB Computer decision support systems are computer applications designed to aid clinicians in making diagnostic and therapeutic decisions in patient care. They can simplify access to data needed to make decisions, provide reminders and prompts at the time of a patient encounter, assist in establishing a diagnosis and in entering appropriate orders, and alert clinicians when new patterns in patient data are recognized. Decision support systems that present patient-specific recommendations in a form that can save clinicians time have been shown to be highly effective, sustainable tools for changing clinician behavior. Designing and implementing such systems is challenging because of the computing infrastructure required, the need for patient data in a machine-processible form, and the changes to existing workflow that may result. Despite these difficulties, there is substantial evidence from trials in a wide range of clinical settings that computer decision support systems help clinicians do a better job caring for patients. As computer-based records and order-entry systems become more common, automated decision support systems will be used more broadly. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Payne, TH (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,Mail Stop S-007-CIM, Seattle, WA 98108 USA. NR 31 TC 50 Z9 52 U1 0 U2 3 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD AUG PY 2000 VL 118 IS 2 SU S BP 47S EP 52S DI 10.1378/chest.118.2_suppl.47S PG 6 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 346NW UT WOS:000088878800008 PM 10939999 ER PT J AU Peters, JI Shelledy, DC Jones, AP Lawson, RW Davis, CP LeGrand, TS AF Peters, JI Shelledy, DC Jones, AP Lawson, RW Davis, CP LeGrand, TS TI A randomized, placebo-controlled study to evaluate the role of salmeterol in the in-hospital management of asthma SO CHEST LA English DT Article DE asthma; beta-agonists; salmeterol ID INHALED SALMETEROL; BRONCHIAL-ASTHMA; SALBUTAMOL; AGONISTS; BRONCHOCONSTRICTION; XINAFOATE; SYMPTOMS; THERAPY AB Study objectives: To assess the safety and efficacy of salmeterol xinafoate as an adjunct to conventional therapy for the in-hospital management of acute asthma, Design: A prospective, double-blind, randomized placebo-controlled trial, Setting: Medical wards of a large university-based hospital. Patients: Forty-three patients admitted for an acute exacerbation of asthma, Interventions: Salmeterol (42 mu g) or two puffs of placebo every 12 h in addition to standard therapy (short-acting beta-agonists, corticosteroids, and anticholinergic agents), Results: No clinically adverse effects were seen with the addition of salmeterol to conventional therapy. After salmeterol, there was no difference in pulse, respiratory rate, oxygen saturation by pulse oximetry, severity of symptoms, or dyspnea score. Patients receiving salmeterol had greater FEV1 percent improvements than the placebo group at 12, 24, 36, and 48 h, These findings were not statistically significant. By paired Student's t tests, there were significant improvements in FEV1 (p = 0.03) and FVC (p = 0.03) in the salmeterol group after 48 h of treatment with no comparable improvement in the placebo group. In a subgroup analysis of patients with an initial FEV1 less than or equal to 1.5 L, the absolute FEV1 percent improvement for salmeterol vs placebo was 51% vs 16% at 24 h and 54% vs 40% at 48 h, The relative FEV1 percent improvement for salmeterol vs placebo was 17% vs 8% at 24 h and 18% vs 14% at 48 h, Conclusion: The addition of salmeterol to conventional therapy is safe and may benefit hospitalized patients with asthma, Further studies are needed to clarify its role in the treatment of acute exacerbation of asthma. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Resp Care, Div Pulm Dis Crit Care Med, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Surg, San Antonio, TX 78284 USA. RP Peters, JI (reprint author), S Texas Vet Hlth Care Syst, Audie L Murphy Mem Vet Hosp Div, Pulm Dis Sect 111E, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. NR 32 TC 21 Z9 21 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD AUG PY 2000 VL 118 IS 2 BP 313 EP 320 DI 10.1378/chest.118.2.313 PG 8 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 344VB UT WOS:000088779200010 PM 10936118 ER PT J AU Robon, MJ Perell, KL Fang, M Guererro, E AF Robon, MJ Perell, KL Fang, M Guererro, E TI The relationship between ankle plantar flexor muscle moments and knee compressive forces in subjects with and without pain SO CLINICAL BIOMECHANICS LA English DT Article DE osteoarthritis; gait; biomechanics; elderly ID OSTEO-ARTHRITIS; OSTEOARTHRITIS; GAIT; REHABILITATION; POPULATION; OBESITY; DISEASE; WOMEN; AGE AB Objective. The purpose of this study was to compare the compressive knee joint reaction force and ankle plantar flexor muscle moment during the terminal stance phase in symptomatic osteoarthritic and non-symptomatic subjects. Design. The study design was a comparative investigation of walking patterns. Background Patients with knee osteoarthritic symptoms may employ altered gait patterns to reduce the loading of painful joints, Speculation is that decreased ankle plantar flexor moments in the terminal stance phase may he an attempt to minimize compressive knee joint reaction forces. Methods. Twenty community-dwelling men (52-83 years old), ten with knee osteoarthritis and ten non-symptomatic, were studied while walking across a walkway containing two force plates at a comfortable speed. Retroreflective markers were placed in accordance with the Helen Hayes marker system and recorded with six 120 Hz cameras. Three-dimensional kinematics and kinetics were computed. Results. Group means for gait velocity, peak ankle plantar flexor moment and compressive knee joint reaction force were significantly less for the osteoarthritic group relative to the non-symptomatic group. When accounting for the decreased velocity in the osteoarthritic group, however, no group differences were observed. There were significant correlations between all three gait parameters (r > 0.75), but peak ankle plantar flexor moment was the greatest predictor of compressive knee joint reaction force, Conclusions. While no group differences were found for compressive knee joint reaction forces when accounting for gait velocity, it appears that subjects with osteoarthritis utilize gait velocity as a mechanism to reduce compressive knee joint reaction forces. (C) 2000 Published by Elsevier Science Ltd. All rights reserved. C1 Univ Calif Los Angeles, W Los Angeles Healthcare Ctr, PM&R Gait Lab 117G, VA Greater Los Angeles Healthcare Syst,Sch Med, Los Angeles, CA 90073 USA. Ohio State Univ, Coll Med, Columbus, OH 43210 USA. Mt St Marys Coll, Los Angeles, CA USA. Kaiser Permanente Med Ctr, Fresno, CA USA. RP Perell, KL (reprint author), Univ Calif Los Angeles, W Los Angeles Healthcare Ctr, PM&R Gait Lab 117G, VA Greater Los Angeles Healthcare Syst,Sch Med, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 26 TC 24 Z9 24 U1 1 U2 3 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0268-0033 J9 CLIN BIOMECH JI Clin. Biomech. PD AUG PY 2000 VL 15 IS 7 BP 522 EP 527 DI 10.1016/S0268-0033(00)00007-3 PG 6 WC Engineering, Biomedical; Orthopedics; Sport Sciences SC Engineering; Orthopedics; Sport Sciences GA 344HV UT WOS:000088753900007 PM 10831812 ER PT J AU Usher, BW O'Brien, TX AF Usher, BW O'Brien, TX TI Recent advances in dobutamine stress echocardiography SO CLINICAL CARDIOLOGY LA English DT Review DE echocardiography; stress testing; dobutamine; diagnostic testing; coronary artery disease ID CORONARY-ARTERY-DISEASE; ACUTE MYOCARDIAL-INFARCTION; EMISSION COMPUTED-TOMOGRAPHY; LEFT-VENTRICULAR FUNCTION; PROGNOSTIC VALUE; CONTRAST ECHOCARDIOGRAPHY; REVERSIBLE DYSFUNCTION; RISK STRATIFICATION; CHEST PAIN; HIBERNATING MYOCARDIUM AB Dobutamine stress echocardiography (DSE) is a reliable cardiac risk stratifier that hac widespread applicability because of its clinical accuracy and cost effectiveness. Dobutamine has positive inotropic and chronotropic effects and is commonly used in patients who cannot exercise or achieve an adequate heart rate response with exercise. Recently available long-term results from several independent clinical trials, combined with enhancements in image quality, have improved the ability to detect significant coronary artery disease and determine myocardial viability. Dobutamine stress echocardiography has an excellent safety profile with clinical results superior to regular exercise electrocardiography and comparable with exercise echocardiography and radionucleotide perfusion stress imaging. Low-dose dobutamine response can accurately predict dysfunctional yet viable myocardial regions that may improve with revascularization. Clinical studies are now available refining the common use of DSE preoperatively in female patients with valvular disease, as well as in the emergency department. Dobutamine stress echocardiography does have some limitations in discriminating particular regions of ischemia when multiple ventricular segments. are involved and when the imaging is suboptimal. It can be applied using minimal additional resources in an otherwise functioning echocardiography laboratory and, with appropriate training, can result in clinical results comparable with those of large-scale multicenter trials. Ongoing improvements in technology and the development of new reagents such as myocardial contrast agents hold promise for further advancement in the near future. C1 Med Univ S Carolina, Dept Med, Div Cardiol, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Med Res Serv, Charleston, SC USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Echocardiog Lab, Charleston, SC USA. Med Univ S Carolina, Gazes Cardiac Res Inst, Charleston, SC 29425 USA. RP O'Brien, TX (reprint author), Med Univ S Carolina, Dept Med, Div Cardiol, 816,CSB,96 Jonathan Lucas St,Suite 816,POB 250623, Charleston, SC 29425 USA. NR 75 TC 9 Z9 11 U1 0 U2 0 PU CLINICAL CARDIOLOGY PUBL CO PI MAHWAH PA PO BOX 832, MAHWAH, NJ 07430-0832 USA SN 0160-9289 J9 CLIN CARDIOL JI Clin. Cardiol. PD AUG PY 2000 VL 23 IS 8 BP 560 EP 570 PG 11 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 340HP UT WOS:000088527300004 PM 10941540 ER PT J AU Talan, DA Summanen, PH Finegold, SM AF Talan, DA Summanen, PH Finegold, SM TI Ampicillin/sulbactam and cefoxitin in the treatment of cutaneous and other soft-tissue abscesses in patients with or without histories of injection drug abuse SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID SKIN-STRUCTURE INFECTIONS; BACTERIOLOGY; SULBACTAM; EFFICACY AB A randomized, double-blind trial compared the clinical and bacteriologic efficacy of ampicillin/sulbactam (2 g/1 g) and cefoxitin (2 g) administered intravenously every 6 h to patients with (n = 49) or without (n = 47) histories of injection drug abuse who presented with cutaneous or other soft-tissue infections. Cure or improvement occurred in 89.8% of ampicillin/sulbactam-treated patients, compared with 93.6% of cefoxitin-treated patients. The median time to resolution of all symptoms was 10.5 days with ampicillin/sulbactam treatment and 15.5 days with cefoxitin treatment. Mixed aerobic-anaerobic infection was encountered frequently in both treatment groups. A significantly higher percentage of Streptococcus species was found in the major abscesses of the patients with histories of injection drug abuse, compared with those without such histories (37% vs. 19%, respectively; P =.0009). Overall, ampicillin/sulbactam eradicated pathogens from the major abscesses in 100% of patients, whereas the eradication rate with cefoxitin was 97.9%, The 2 drugs were well tolerated. Ampicillin/sulbactam and cefoxitin were equally effective for the empirical treatment of cutaneous or other soft-tissue infections in injection drug abusers and patients who did not inject drugs. C1 Olive View UCLA Med Ctr, Dept Med, Div Emergency Med & Infect Dis, Sylmar, CA 91342 USA. W Los Angeles Vet Affairs Med Ctr, Res Serv, W Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Infect Dis Sect, W Los Angeles, CA USA. RP Talan, DA (reprint author), Olive View UCLA Med Ctr, Dept Emergency Med, 14445 Olive View Dr,N Annex, Sylmar, CA 91342 USA. NR 31 TC 14 Z9 15 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG PY 2000 VL 31 IS 2 BP 464 EP 471 DI 10.1086/313971 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 363MD UT WOS:000089838700010 PM 10987706 ER PT J AU Castle, SC AF Castle, SC TI Clinical relevance of age-related immune dysfunction SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID INFLUENZA VACCINATION; PERIPHERAL-BLOOD; DENDRITIC CELLS; NEUTROPHIL FUNCTION; ELDERLY SUBJECTS; UP-REGULATION; IMMUNOSENESCENCE; PROLIFERATION; MACROPHAGES; DECADES AB Immunosenescence is the state of dysregulated immune function that contributes to the increased susceptibility to infection of the elderly. Extensive studies of inbred laboratory animals and very healthy elderly humans have identified changes in immunity; these studies have identified limited phenotypic and functional changes in the T cell component of adaptive immunity. However, no compelling scientific evidence has shown that these changes have direct relevance to the common infections seen in the aged population. This perspective will attempt to shed light on this dilemma. First, it will review clinically relevant infections in the elderly, focusing on influenza and influenza virus vaccination and how chronic illness contributes to increased risk and severity of infection and/or failed vaccine response. Second, key changes in immunity will be reviewed, keeping a perspective of the impact of confounding variables in addition to age but focusing on age-related changes in the interaction of the innate and acquired components of immunity. If the goal is to prevent serious infections in the elderly, it appears that the field of geriatric immunology and/or infectious diseases is faced with the tremendous challenge of studying a very diverse population, including mildly immunocompromised/chronically ill individuals and very healthy elderly. C1 VA Greater Los Angeles Healthcare Syst, GRECC 11G, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. RP Castle, SC (reprint author), VA Greater Los Angeles Healthcare Syst, GRECC 11G, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 35 TC 302 Z9 315 U1 0 U2 8 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG PY 2000 VL 31 IS 2 BP 578 EP 585 DI 10.1086/313947 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 363MD UT WOS:000089838700028 PM 10987724 ER PT J AU Lee, A Boone, KB Lesser, I Wohl, M Wilkins, S Parks, C AF Lee, A Boone, KB Lesser, I Wohl, M Wilkins, S Parks, C TI Performance of older depressed patients on two cognitive malingering tests: False positive rates for the Rey 15-item Memorization and Dot Counting Tests SO CLINICAL NEUROPSYCHOLOGIST LA English DT Article AB To our knowledge, no investigations have been undertaken to determine whether depression impacts performance on two commonly used tests to detect malingering of cognitive symptoms, the Rey 15-item Memorization Test and the Rey Dot Counting Test. This is a critical issue because of the high rate of depressive symptoms in patients with neurological conditions. It was hypothesized that depressed individuals, especially those with more severe depression, might be at risk for failing the tests, because these patients exhibit mild deficits in mental speed, visual perceptual/spatial skills, and visual memory, abilities required for successful completion of the malingering tests. However, examination of test performance in 64 older participants with major depression generally revealed very low false positive rates for most test scores, and severity of depression was unrelated to test scores. These results add to accumulating data supporting the validity of these cognitive malingering tests by documenting few false positive identifications. C1 Harbor UCLA Med Ctr, Dept Psychiat, Torrance, CA 90509 USA. W Los Angeles Vet Adm, Los Angeles, CA 90073 USA. Calif Sch Profess Psychol, Los Angeles, CA 90073 USA. RP Boone, KB (reprint author), Harbor UCLA Med Ctr, Dept Psychiat, Box 495,1000 W Carson St,F-9, Torrance, CA 90509 USA. NR 21 TC 16 Z9 16 U1 3 U2 5 PU SWETS ZEITLINGER PUBLISHERS PI LISSE PA P O BOX 825, 2160 SZ LISSE, NETHERLANDS SN 0920-1637 J9 CLIN NEUROPSYCHOL JI Clin. Neuropsychol. PD AUG PY 2000 VL 14 IS 3 BP 303 EP 308 DI 10.1076/1385-4046(200008)14:3;1-P;FT303 PG 6 WC Psychology, Clinical; Clinical Neurology; Psychology SC Psychology; Neurosciences & Neurology GA 392FV UT WOS:000166401600006 PM 11262705 ER PT J AU Wirshing, DA AF Wirshing, DA TI Social skills training for schizophrenia: A step by-step guide. SO COMMUNITY MENTAL HEALTH JOURNAL LA English DT Book Review C1 W Los Angeles Vet Affairs Med Ctr, Schizophrenia Res & Treatment Unit, Los Angeles, CA 90073 USA. RP Wirshing, DA (reprint author), W Los Angeles Vet Affairs Med Ctr, Schizophrenia Res & Treatment Unit, 11301 Wilshire Blvd,B-151H,Bldg 210B,Room 15, Los Angeles, CA 90073 USA. NR 1 TC 0 Z9 0 U1 0 U2 1 PU KLUWER ACADEMIC-HUMAN SCIENCES PRESS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0010-3853 J9 COMMUNITY MENT HLT J JI Community Ment. Health J. PD AUG PY 2000 VL 36 IS 4 BP 452 EP 453 DI 10.1023/A:1001925315922 PG 2 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 330NC UT WOS:000087967300012 ER PT J AU Bauer, TR Hickstein, DD AF Bauer, TR Hickstein, DD TI Gene therapy for leukocyte adhesion deficiency SO CURRENT OPINION IN MOLECULAR THERAPEUTICS LA English DT Article DE CD11/CD18; heterodimer; leukocyte adherence deficiency; neutophil ID RECURRENT BACTERIAL-INFECTIONS; INTEGRIN CD18 SUBUNIT; APE LEUKEMIA-VIRUS; BETA-SUBUNIT; RETROVIRAL VECTORS; PERIPHERAL-BLOOD; MOLECULAR-BASIS; ANIMAL-MODEL; CELLS; LFA-1 AB Leukocyte adhesion deficiency (LAD) is an autosomal recessive immunodeficiency disease characterized by severe, recurrent bacterial infections. In patients with LAD, the leukocytes, particularly the neutrophils, fail to adhere to the endothelial cell wall and migrate to the site of infection. LAD results from heterogeneous molecular defects in the leukocyte integrin CD18, which prevent CD11/CD18 heterodimer formation and surface expression. To date, hematopoietic stem cell transplantation remains the only curative treatment for LAD, however, this approach is limited try transplant-related toxicities and graft-versus-host disease. During the course of the preceding decade we have conducted extensive experimental studies demonstrating that gene transfer of the CD18 subunit corrects the structural and functional defect in LAD leukocytes. These studies provided the support for the initiation of a clinical trial of retroviral-mediated gene transfer of CD18 in two patients with the severe deficiency phenotype or LAD. This review will present an overview of LAD, preclinical CD18 gene transfer studies and the initial results from the current clinical trial. C1 Univ Washington, Dept Med, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Bauer, TR (reprint author), Univ Washington, Dept Med, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way 151, Seattle, WA 98108 USA. NR 56 TC 28 Z9 30 U1 0 U2 0 PU PHARMAPRESS LTD PI LONDON PA MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON W1P 6LB, ENGLAND SN 1464-8431 J9 CURR OPIN MOL THER JI Curr. Opin. Mol. Ther. PD AUG PY 2000 VL 2 IS 4 BP 383 EP 388 PG 6 WC Biotechnology & Applied Microbiology; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Research & Experimental Medicine GA 345WR UT WOS:000088838600004 PM 11249768 ER PT J AU Fujikawa, TG Itabashi, HH Wu, AG Shinmei, SS AF Fujikawa, TG Itabashi, HH Wu, AG Shinmei, SS TI Status epilepticus-induced neuronal loss in humans without systemic complications or epilepsy SO EPILEPSIA LA English DT Article DE status epilepticus; seizures; cell death; neuronal necrosis; gliosis ID NEUROLEPTIC MALIGNANT SYNDROME; TEMPORAL-LOBE EPILEPSY; DOMOIC ACID INTOXICATION; NMDA RECEPTOR ANTAGONIST; KAINIC ACID; BRAIN-DAMAGE; LITHIUM-PILOCARPINE; ENTORHINAL CORTEX; LIMBIC SEIZURES; CELL LOSS AB Purpose: To determine the regional distribution of neuronal damage caused strictly by status epilepticus (SE) without systemic complications, underlying brain pathology, or a history of preexisting epilepsy. Methods: The medical records and electroencephalograms (EEGs) of three deceased patients who developed SE in the hospital were reviewed. Their brains were formalin-fixed, and 17 brain regions were selected, embedded in paraffin, and sectioned. Alternate sections were stained with either hematoxylin and eosin and cresyl violet to determine the extent of neuronal loss and gliosis or glial fibrillary astrocytic protein to confirm the extent of astrocytic proliferation. Results: The three patients died 11 to 27 days after the onset of focal motor SE; none had hypotension, hypoxemia, hypoglycemia, or significant hyperthermia. Two patients had no prior seizures and no underlying brain pathology. The third patient, who had leptomeningeal carcinomatosis, had one seizure 2 months before the onset of SE. The duration of SE was 8.8 hours to 3 days. EEGs showed unilateral temporal lobe sharp-wave discharges in one patient and independent temporal lobe sharp-wave discharges bilaterally in the other two patients. In addition to widespread neuronal loss and reactive gliosis in the hippocampus, amygdala, dorsomedial thalamic nucleus, and Purkinje cell layer of the cerebellum we report for the first time periamygdaloid (piriform) and entorhinal cortical damage occurring acutely after SE in humans. Conclusions: In the absence of systemic complications or preexisting epilepsy, SE produces neuronal loss in a distribution similar to that from domoic acid-induced SE in humans and from kainic acid- and pilocarpine-induced SE in rats. C1 VA Greater Los Angeles Healthcare Syst, Neurol Dept 127, Sepulveda Ambulatory Care Ctr, Sepulveda, CA 91343 USA. VA Greater Los Angeles Healthcare Syst, Neurol Dept 127, Nursing Home Care Unit, Sepulveda, CA 91343 USA. VA Greater Los Angeles Healthcare Syst, Expt Neurol Lab, Sepulveda Ambulatory Care Ctr, Sepulveda, CA 91343 USA. VA Greater Los Angeles Healthcare Syst, Expt Neurol Lab, Nursing Home Care Unit, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Pathol, Los Angeles, CA 90024 USA. RP Fujikawa, TG (reprint author), VA Greater Los Angeles Healthcare Syst, Neurol Dept 127, Sepulveda Ambulatory Care Ctr, 16111 Plummer St, Sepulveda, CA 91343 USA. EM dfujikaw@ucla.edu NR 48 TC 23 Z9 24 U1 0 U2 2 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0013-9580 EI 1528-1167 J9 EPILEPSIA JI Epilepsia PD AUG PY 2000 VL 41 IS 8 BP 981 EP 991 PG 11 WC Clinical Neurology SC Neurosciences & Neurology GA 342TJ UT WOS:000088661000011 ER PT J AU Rowan, AJ AF Rowan, A. James TI What We Owe Our Seniors with Epilepsy-Thoughts on Quality of Life SO EPILEPSY & BEHAVIOR LA English DT Editorial Material C1 Bronx Vet Adm Med Ctr, Bronx, NY 10468 USA. RP Rowan, AJ (reprint author), Bronx Vet Adm Med Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. NR 1 TC 5 Z9 5 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1525-5050 J9 EPILEPSY BEHAV JI Epilepsy Behav. PD AUG PY 2000 VL 1 IS 4 BP 215 EP 216 DI 10.1006/ebeh.2000.0087 PG 2 WC Behavioral Sciences; Clinical Neurology; Psychiatry SC Behavioral Sciences; Neurosciences & Neurology; Psychiatry GA V21JM UT WOS:000208203900008 ER PT J AU Rahimtoola, SH Sethi, GK Henderson, WG Grover, FL Oprian, C Hammermeister, K AF Rahimtoola, SH Sethi, GK Henderson, WG Grover, FL Oprian, C Hammermeister, K CA Participants Vet Adm Cooperative TI Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Administration randomized trial SO EUROPEAN HEART JOURNAL LA English DT Meeting Abstract C1 Univ So Calif, Keck Sch Med, Vet Adm Cooperat Study Valvular Heart Dis, Los Angeles, CA USA. Tucson VA Med Ctr, Vet Adm Cooperat Study Valvular Heart Dis, Tucson, AZ USA. Edward Hines Vet Adm Med Ctr, Vet Adm Cooperat Study Valvular Heart Dis, Hines, IL 60141 USA. Denver VA Med Ctr, Vet Adm Cooperat Study Valvular Heart Dis, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU W B SAUNDERS CO LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0195-668X J9 EUR HEART J JI Eur. Heart J. PD AUG-SEP PY 2000 VL 21 SU S MA 2076 BP 379 EP 379 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 351BR UT WOS:000089136601474 ER PT J AU Lavrovsky, Y Chatterjee, B Clark, RA Roy, AK AF Lavrovsky, Y Chatterjee, B Clark, RA Roy, AK TI Role of redox-regulated transcription factors in inflammation, aging and age-related diseases SO EXPERIMENTAL GERONTOLOGY LA English DT Review DE atherosclerosis; peroxisome proliferator; nuclear factor kappa B ID NF-KAPPA-B; VASCULAR ENDOTHELIAL-CELLS; ACTIVATED RECEPTOR-ALPHA; GLUCOCORTICOID RECEPTOR; GENE-EXPRESSION; NEGATIVE REGULATOR; ANDROGEN RECEPTOR; OXIDIZED LDL; BINDING; OXIDASE AB A progressive rise of oxidative stress due to the altered redox homeostasis appears to be one of the hallmarks of the aging process. Reactive oxygen species (ROS) also serve as signaling agents for inflammation, a systemic defensive reaction against microbial pathogens and other foreign bodies. Changes in the pattern of gene expression through ROS-sensitive transcription factors give rise to both aging and inflammation phenotypes, Chronic oxidative stress and inflammatory reaction also lead to many age-associated diseases such as atherosclerosis and arthritis. Transcription factors that are directly influenced by ROS and proinflammatory cytokines include nuclear factor kappa B (NF-kappa B), activator protein 1 (AP-1), specificity protein 1 (Sp1), peroxisome proliferator-activated receptors (PPARs) and other members of the nuclear receptor superfamily. Here we describe the basic components of the intracellular redox control machinery and their dysregulation with age leading to altered transcription factor function and age-associated pathophysiology. (C) 2000 Elsevier Science Inc. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Roy, AK (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NIA NIH HHS [R01 AG019519, R37 AG 10486]; NIAID NIH HHS [R01 AI020866, R37 AI 20866, R37 AI020866]; NIDDK NIH HHS [DK 14744] NR 57 TC 171 Z9 178 U1 0 U2 14 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0531-5565 J9 EXP GERONTOL JI Exp. Gerontol. PD AUG PY 2000 VL 35 IS 5 BP 521 EP 532 DI 10.1016/S0531-5565(00)00118-2 PG 12 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 358TU UT WOS:000089573900002 PM 10978675 ER PT J AU Jensen, DM AF Jensen, DM TI What to choose for diagnosis of bleeding colonic angiomas: Colonoscopy, angiography, or helical computed tomography angiography? SO GASTROENTEROLOGY LA English DT Editorial Material C1 Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Los Angeles, CA USA. RP Jensen, DM (reprint author), VA Med Ctr W Los Angeles, 11301 Wilshire Blvd,CURE Bldg 115,Room 318, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [1K24DK02650, DK33273, DK41301] NR 9 TC 6 Z9 6 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD AUG PY 2000 VL 119 IS 2 BP 581 EP 583 DI 10.1053/gast.2000.16275 PG 3 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 350EB UT WOS:000089086800031 PM 10930391 ER PT J AU Moss, MH Bush, RK AF Moss, MH Bush, RK TI Patient selection and administration of aeroallergen vaccines SO IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA LA English DT Article ID GRASS-POLLEN IMMUNOTHERAPY; DOUBLE-BLIND TRIAL; CAT-INDUCED ASTHMA; ALLERGEN IMMUNOTHERAPY; HAY-FEVER; RUSH IMMUNOTHERAPY; CLADOSPORIUM-HERBARUM; CLINICAL EFFICACY; MOLD ALLERGY; PRICK TESTS AB Immunotherapy often is used as a treatment fur allergic diseases such as allergic rhinitis and asthma. The acceptance of immunotherapy for treating allergic rhinitis or asthma has been previously limited by the historical lack of adequate numbers of double-blind, placebo-controlled trials of specific allergen immunotherapy involving Large numbers of patients. Nonetheless, numerous studies have shown that immunotherapy for allergic respiratory diseases significantly reduces the severity of symptoms and medication requirements. Criteria can help in selecting patients in whom immunotherapy will be beneficial with minimal risks. C1 William S Middleton Mem Vet Hosp, Madison, WI 53705 USA. Univ Wisconsin Hosp & Clin, Allergy & Immunol Sect, Madison, WI 53792 USA. RP Bush, RK (reprint author), William S Middleton Mem Vet Hosp, 2500 Overlook Terrace, Madison, WI 53705 USA. NR 72 TC 1 Z9 1 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0889-8561 J9 IMMUNOL ALLERGY CLIN JI Immunol. Allerg. Clin. North Am. PD AUG PY 2000 VL 20 IS 3 BP 533 EP + DI 10.1016/S0889-8561(05)70165-X PG 21 WC Allergy; Immunology SC Allergy; Immunology GA 347YT UT WOS:000088957300006 ER PT J AU Brook, RH McGlynn, EA Shekelle, PG AF Brook, RH McGlynn, EA Shekelle, PG TI Defining and measuring quality of care: a perspective from US researchers SO INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE LA English DT Article DE health care; health services evaluation; quality assessment; quality improvement ID UPPER GASTROINTESTINAL ENDOSCOPY; NEW-YORK-CITY; HEALTH-CARE; CAROTID ENDARTERECTOMY; CORONARY REVASCULARIZATION; MORTALITY DIFFERENCES; VOLUNTARY HOSPITALS; MANAGED CARE; NEW-MEXICO; SYSTEM AB The modern quality field in medicine is about one-third of a century old. The purpose of this paper is to summarize what we know about quality of care and indicate what we can do to improve quality of care in the next century. We assert that quality can be measured, that quality of care varies enormously, that improving quality of care is difficult, that financial incentives directed at the health system level have little effect on quality and that we lack a publicly available tool kit to assess quality. To improve quality of care we will need adequate data and that will require patients to provide information about what happened to them and to allow people to abstract their medical records. It also will require that physicians provide patient information when asked. We also need a strategy to measure quality and then report the results and we need to place in the public domain tool kits that can be used by physicians, administrators, and patient groups to assess and improve quality. Each country should have a national quality report, based on standardized comprehensive and scientifically valid measures, which describes the country's progress in improving quality of care. We can act now. For the 70-100 procedures that dominate what physicians do, we should have a computer-based, prospective system to ensure that physicians ask patients the questions required to decide whether to do the procedure. The patient should verify the responses. Answers from patients should be combined with test results and other information obtained from the patient's physician to produce an assessment of the procedure's appropriateness and necessity. Advanced tools to assess quality, based on data from the patient and medical records, are also currently being developed. These tools could be used to comprehensively assess the quality of primary care across multiple conditions at the country, regional, and medical group level. C1 RAND Corp, Hlth Program, Santa Monica, CA 90407 USA. Univ Calif Los Angeles, Ctr Hlth Sci, Los Angeles, CA USA. Greater Los Angeles Vet Adm Hlth Care Syst, Los Angeles, CA USA. RP Brook, RH (reprint author), RAND Corp, Hlth Program, 1700 Main St,POB 2138, Santa Monica, CA 90407 USA. NR 45 TC 145 Z9 152 U1 0 U2 10 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 1353-4505 J9 INT J QUAL HEALTH C JI Int. J. Qual. Health Care PD AUG PY 2000 VL 12 IS 4 BP 281 EP 295 DI 10.1093/intqhc/12.4.281 PG 15 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 349TR UT WOS:000089062100005 PM 10985266 ER PT J AU Kaminski, MJ Mroczkowski, TF Krotoski, WA AF Kaminski, MJ Mroczkowski, TF Krotoski, WA TI Dendritic epidermal gamma/delta T cells (DETC) activated in vivo proliferate in vitro in response to Mycobacterium leprae antigens SO INTERNATIONAL JOURNAL OF DERMATOLOGY LA English DT Article ID HEAT-SHOCK PROTEIN; GAMMA-DELTA-CELLS; TUBERCULOSIS; IRRITANTS; STIMULATION; SPECIFICITY; EXPRESSION; RECEPTORS; SKIN AB Background gamma/delta T-cell receptor (TCR)+ dendritic epidermal T cells (DETC) are part of a primitive defense system in the skin; they are capable of responding only to a limited number of antigens. The aim of the present study was to test whether DETC can proliferate in vitro in response to antigens of Mycobacterium leprae. Methods DETC were obtained from CBA mouse ear skin by trypsinization and Histopaque gradient centrifugation. The resulting epidermal cell suspension contained up to 20% DETC, as analyzed by the fluorescence activated cell sorter (FACS) after staining with anti-Thy-1 or anti-gamma/delta TCR monoclonal antibodies (mAbs). The freshly isolated cells, or DETC cultured up to 4 weeks with interleukin-2 (IL-2), were exposed in vitro for up to 6 days to varying doses of the following M. leprae antigens: (1) integral (live) M. leprae bacilli; (2) Dharmendra antigen; and (3) PGL-1 (phenolic glycolipid of M. leprae). The DETC response was assessed by tritiated thymidine (H-3-TdR) incorporation. Results The freshly isolated DETC, or DETC cultured up to 4 weeks with IL-2, did not respond significantly to any of the M. leprae antigens, although at the same time they were able to respond vigorously to concanavalin A (Con A), as positive control. If, however, DETC were isolated from skin, painted 7 days before with croton oil (10 mu L/cm(2) to cause irritant dermatitis, they were able to respond to all M. leprae antigens by a 3-4-fold incrase in the H-3-TdR uptake. The most effective stimulator was a 1 : 1 mixture of Dharmendra and PGL-1 (0.01 mu g/mL), which was as effective as in-fold higher doses of either antigen alone. Cell counts confirmed that increased DNA synthesis was associated with cell proliferation. Experiments employing alpha/beta-TCR CBA murine spleen cells and epidermal cell suspension treated with anti-gamma/delta or anti alpha/beta mAbs+C' proved that only the gamma/delta DETC were the responder cells to M. leprae antigens. Conclusions The results suggest that activation of DETC in vivo may make them responsive to M. leprae antigens. A significant increase in the number of class II major histocompatibility complex (MHC) positive, nondendritic cells was observed in the croton oil-treated epidermis. We hypothesize that croson oil-induced upregulation of class II MHC expression, which endows epidermal cells with antigen-presenting capabilities, might be an important factor in vivo in delivering an immunogenic signal to resident DETC in the skin. C1 Tulane Univ, Med Ctr, Dept Dermatol, New Orleans, LA 70112 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Vet Adm Hosp, San Antonio, TX USA. Gillis W Long Hansens Dis Ctr, Carville, LA USA. RP Mroczkowski, TF (reprint author), Tulane Univ, Med Ctr, Dept Dermatol, 1430 Tulane Ave, New Orleans, LA 70112 USA. NR 29 TC 4 Z9 5 U1 0 U2 2 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND SN 0011-9059 J9 INT J DERMATOL JI Int. J. Dermatol. PD AUG PY 2000 VL 39 IS 8 BP 603 EP 608 DI 10.1046/j.1365-4362.2000.00966.x PG 6 WC Dermatology SC Dermatology GA 351KT UT WOS:000089156900008 PM 10971729 ER PT J AU Mosko, P AF Mosko, P TI Factors affecting patient satisfaction with follow-up by a nurse practitioner in an outpatient rheumatology clinic - Commentary SO JCR-JOURNAL OF CLINICAL RHEUMATOLOGY LA English DT Editorial Material C1 Philadelphia VA Med Ctr, Philadelphia, PA USA. RP Mosko, P (reprint author), Philadelphia VA Med Ctr, Philadelphia, PA USA. NR 13 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1076-1608 J9 JCR-J CLIN RHEUMATOL JI JCR-J. Clin. Rheumatol. PD AUG PY 2000 VL 6 IS 4 BP 188 EP 188 PG 1 WC Rheumatology SC Rheumatology GA 343PX UT WOS:000088711700005 ER PT J AU Wang, C Swerdloff, RS Iranmanesh, A Dobs, A Snyder, PJ Cunningham, G Matsumoto, AM Weber, T Berman, N AF Wang, C Swerdloff, RS Iranmanesh, A Dobs, A Snyder, PJ Cunningham, G Matsumoto, AM Weber, T Berman, N CA Testosterone Gel Study Grp TI Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID CLINICAL-RESEARCH CENTER; REPLACEMENT THERAPY; LONG-TERM; ANDROGEN REPLACEMENT; PROTEIN-SYNTHESIS; PHARMACOKINETICS; SYSTEM; MASS; BEHAVIOR; EFFICACY AB Testosterone (T) therapy for hypogonadal men should correct the clinical abnormalities of T deficiency, including improvement of sexual function, increase in muscle mass and strength, and decrease in fat mass, with minimal adverse effects. We have shown that administration of a new transdermal T gel formulation to hypogonadal men provided dose proportional increases in serum T levels to the normal adult male range. We now report the effects of 180 days of treatment with this 1% T gel preparation (50 or 100 mg/day, contained in 5 or 10 g gel, respectively) compared to those of a permeation-enhanced T patch (5 mg/day) on defined efficacy parameters in 227 hypogonadal men. In the T gel groups, the T dose was adjusted up or down to 75 mg/day (contained in 7.5 g gel) on day 90 if serum T concentrations were below or above the normal male range. No dose adjustment was made with the T patch group. Sexual function and mood changes were monitored by questionnaire, body composition was determined by dual energy x-ray absorptiometry, and muscle strength was measured by the one repetitive maximum technique on bench and leg press exercises. Sexual function and mood improved maximally on day 30 of treatment, without differences across groups, and showed no further improvement with continuation of treatment. Mean muscle strength in the leg press exercise increased by 11 to 13 kg in all treatment groups by 90 days and did not improve further at 180 days of treatment. Moderate increases were also observed in arm/chest muscle strength. At 90 days of treatment, lean body mass increased more in the 100 mg/day T gel group (2.74 +/- 0.28 kg; P = 0.0002) than in the 50 mg/day T gel (1.28 +/- 0.32 kg) and T patch groups (1.20 +/- 0.26 kg). Fat mass and percent fat were not significantly decreased in the T patch group, but showed decreases in the T gel groups (50 mg/day, -0.90 +/- 0.32 kg; 100 mg/day, -1.05 +/- 0.22 kg). The increase in lean mass and the decrease in fat mass were correlated with the changes in average serum T levels attained after transdermal T replacement. These beneficial effects of T replacement were accompanied by the anticipated increases in hematocrit and hemoglobin but without significant changes in the lipid profile. The increase in mean serum prostate-specific antigen levels (within the normal range) was correlated with serum levels of T. The greatest increases were noted in the 100 mg/day T gel group. Shin irritation was reported in 5.5% of subjects treated with T gel and in 66% of subjects in the permeation-enhanced T patch group. We conclude that T gel replacement improved sexual function and mood, increased lean mass and muscle strength (principally in the legs), and decreased fat mass in hypogonadal men with less skin irritation and discontinuation compared with the recommended dose of the permeation-enhanced T patch. C1 Univ Calif Los Angeles, Los Angeles Cty Harbor Med Ctr, Dept Med, Div Endocrinol, Torrance, CA 90509 USA. Univ Calif Los Angeles, Los Angeles Cty Harbor Med Ctr, Dept Pediat, Div Endocrinol, Torrance, CA 90509 USA. Res & Educ Inst, Torrance, CA 90509 USA. Vet Affairs Med Ctr, Salem, VA 24153 USA. Johns Hopkins Univ, Baltimore, MD 21287 USA. Univ Penn, Med Ctr, Philadelphia, PA 19104 USA. Baylor Coll Med, Vet Affairs Med Ctr, Houston, TX 77030 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Duke Univ, Med Ctr, Durham, NC 27705 USA. RP Wang, C (reprint author), Univ Calif Los Angeles, Los Angeles Cty Harbor Med Ctr, Dept Med, Div Endocrinol, 1000 W Carson St, Torrance, CA 90509 USA. FU PHS HHS [M0-00543] NR 44 TC 509 Z9 528 U1 6 U2 32 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X EI 1945-7197 J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD AUG PY 2000 VL 85 IS 8 BP 2839 EP 2853 DI 10.1210/jc.85.8.2839 PG 15 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 381VQ UT WOS:000165784500035 PM 10946892 ER PT J AU Christakis, DA Saint, S Saha, S Elmore, JG Welsh, DE Baker, P Koepsell, TD AF Christakis, DA Saint, S Saha, S Elmore, JG Welsh, DE Baker, P Koepsell, TD TI Do physicians judge a study by its cover? An investigation of journal attribution bias SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE evidence based medicine; meta-analysis; blinding; bias AB The effect of a journal's prestige on readers' impressions of an article is unknown. Two hypotheses were tested: first, that attribution of a study to a " high" prestige journal would be associated with improved impressions and attribution to a "low" prestige journal would be associated with diminished impressions; and second, that formal training in epidemiology and biostatistics would mitigate the effects of this journal attribution bias. The study was designed as a trial among a random sample of 264 internists. Participants were asked to read an article and an abstract from either the Southern Medical Journal (SMJ) or the New England Journal of Medicine (NEJM). Questionnaires were constructed that either attributed the article or abstract to its source or presented it as unattributed. After each article or abstract, respondents were asked to rate the quality of the study, the appropriateness of the methodology employed, the significance of the findings, and its likely effects on their practice. A 20-point impression score was created based on responses to these statements. The effect of attribution to a specific journal and formal epidemiology training on impression scores were assessed using linear regression. Of the 399 eligible participants, 264 questionnaires were returned (response rate 66%). Differences in impression scores associated with attribution of an article or abstract to the NEJM were .71 [95% C.I. (-.44-1.87)] and .50 [95% C.I. (-.87-1.87)] respectively; differences in impression scores associated with attribution of an article or abstract to the SMJ were -.12 [95% C.I. (-1.53-1.30)] and -.95 [95% C.I. (-2.41-.52)]. A stratified analysis demonstrated that epidemiology training did not meaningfully alter the effect of journal attribution on participants' impression scores. If journal attribution bias exists, it is likely to exert small and clinically insignificant effects when physicians read articles carefully. Formal training in epidemiology and biostatistics does not appear to alter these results. (C) 2000 Elsevier science Inc. All rights reserved. C1 Univ Washington, Inst Child Hlth, Seattle, WA 98103 USA. Univ Washington, Div Gen Pediat, Seattle, WA 98195 USA. Univ Michigan, Div Gen Internal Med, Ann Arbor, MI 48109 USA. Oregon Hlth Sci Univ, Portland VA Med Ctr, Div Gen Internal Med, Portland, OR 97201 USA. Univ Washington, Div Gen Internal Med, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Ann Arbor VA Hlth Serv Res & Dev, Ann Arbor, MI USA. Seattle VA Med Ctr, Seattle, WA USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. RP Christakis, DA (reprint author), Univ Washington, Inst Child Hlth, 146 N Canal St,Suite 300, Seattle, WA 98103 USA. NR 11 TC 3 Z9 4 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD AUG PY 2000 VL 53 IS 8 BP 773 EP 778 DI 10.1016/S0895-4356(99)00236-X PG 6 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 347CA UT WOS:000088908400001 PM 10942858 ER PT J AU Patrick, DL Kinne, S Engelberg, RA Pearlman, RA AF Patrick, DL Kinne, S Engelberg, RA Pearlman, RA TI Functional status and perceived quality of life in adults with and without chronic conditions SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT 10th National Conference on Disability and Health CY OCT 14-16, 1998 CL DALLAS, TEXAS DE health status; quality of life; chronic conditions; disability evaluation; functional status; depression ID OF-LIFE; PEOPLE; CARE; SATISFACTION; DISABILITIES; DEPRESSION; EXERCISE AB The objective of this study was to evaluate the association between self-reported functional status and quality of life in adults with and without chronic conditions. Data were obtained on functional status (Sickness Impact Profile, SIP), and perceived quality of life (Perceived Quality of Life Scale, PQoL) from 454 persons in nine groups with widely varying levels of functional status and disability. Multiple regression was used to analyze the association controlling for demographic characteristics (age, gender, educational level, income, marital status), self-rated health status, and depressive symptoms. PQoL was lowest for persons using wheelchairs and highest for older well adults. Scores decreased as SIP scores increased. Overall, being older, reporting better functional status, and having fewer depressive symptoms were significantly associated with higher quality of life (adjusted R-2 = 0.60). This pattern held for most subgroups, although the association was much lower for adults with AIDS and younger well adults where ceiling effects were observed in functional status. Functional status and perceived quality of life are highly associated but are distinct in many populations. Depressive symptoms and self-rated health are important mediators of the relationship to include in future studies. Amelioration of depressive symptoms through environmental modification and individual treatment are potential strategies for improving on this association in adults with chronic conditions. (C) 2000 Elsevier Science Inc. All rights reserved. C1 Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. RP Patrick, DL (reprint author), Univ Washington, Dept Hlth Serv, 1959 NE Pacific,Box 357660, Seattle, WA 98195 USA. FU PHS HHS [U48/CCU00954] NR 32 TC 55 Z9 56 U1 0 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD AUG PY 2000 VL 53 IS 8 BP 779 EP 785 DI 10.1016/S0895-4356(00)00205-5 PG 7 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 347CA UT WOS:000088908400002 PM 10942859 ER PT J AU Bialek, R Ibricevic, A Aepinus, C Najvar, LK Fothergill, AW Knobloch, J Graybill, JR AF Bialek, R Ibricevic, A Aepinus, C Najvar, LK Fothergill, AW Knobloch, J Graybill, JR TI Detection of Paracoccidioides brasiliensis in tissue samples by a nested PCR assay SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID POLYMERASE CHAIN-REACTION; EXPRESSION; CLONING AB A nested PCR assay for the detection of Paracoccidioides brasiliensis DNA was evaluated, using a sequence of the immunogenic gp43 gene as a target. This gene encodes an outer membrane protein unique to this dimorphic fungus. DNA from six clinical isolates and the ATCC strain 60885 of P. brasiliensis, as well as DNA from closely related fungi, was examined to determine detection limits and cross-reactions. PCR was done on DNA extracts of lung homogenates from 23 experimentally P. brasiliensis-infected and two uninfected BALB/c mice and from 20 Histoplasma capsulatum-infected ICR mice. The results were compared to quantitative cultures. A detection limit of 0.5 fg of specific DNA was determined using cloned plasmid DNA. In all seven P. brasiliensis isolates, the expected 196-bp nested PCR product was found. Their sequences were 100% identical to the gp43 gene sequence in GenBank. DNA extracts of all other, related fungi were negative. The PCR assay was positive in 21 out of 23 culture-positive lung homogenates with concentrations of 1 x 10(3) to 1.3 x 10(7) CFU of P. brasiliensis per g of lung. Uninfected BALB/c mice and H. capsulatum-infected mice samples gave negative results. The high sensitivity and specificity of this new nested PCR assay for the detection of P. brasiliensis in tissue samples were demonstrated. The assay may be useful for diagnosis in human tissue samples. C1 Univ Tubingen Hosp, Inst Trop Med, D-72074 Tubingen, Germany. Univ Tubingen Hosp, Dept Mol Pathol, D-72074 Tubingen, Germany. Audie L Murphy Mem Vet Hosp, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78284 USA. RP Bialek, R (reprint author), Univ Tubingen Hosp, Inst Trop Med, Keplerstr 15, D-72074 Tubingen, Germany. NR 13 TC 50 Z9 53 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD AUG PY 2000 VL 38 IS 8 BP 2940 EP 2942 PG 3 WC Microbiology SC Microbiology GA 340XL UT WOS:000088561700025 PM 10921955 ER PT J AU Yeh, CK Johnson, DA Dodds, MWJ Sakai, S Rugh, JD Hatch, JP AF Yeh, CK Johnson, DA Dodds, MWJ Sakai, S Rugh, JD Hatch, JP TI Association of salivary flow rates with maximal bite force SO JOURNAL OF DENTAL RESEARCH LA English DT Article DE salivary flow; bite force; aging ID MASSETER MUSCLE; PAROTID SECRETION; PERIODONTAL MECHANORECEPTORS; MASTICATORY PERFORMANCE; CRANIOMANDIBULAR INDEX; COMPUTED-TOMOGRAPHY; NATURAL DENTITION; GLAND; HUMANS; DIET AB Mean salivary secretion and bite force decrease with advancing age. Previous studies have shown that salivary flow rates are influenced by mastication. In the present study, we examined the relationship between salivary flow rates and maximal bite force in a community-based sample of men and women 35 years of age or older. Salivary flow rates for unstimulated whole and unstimulated submandibular/sublingual (SMSL) saliva as well as citrate-stimulated parotid and SMSL saliva were measured in 399 subjects. Bite force was assessed with a bilateral force transducer. Pearson correlation analysis yielded significant positive correlations between bite force and flow rates for unstimulated whole saliva (r = 0.24, p < 0.0001), stimulated parotid saliva (r = 0.13, p < 0.03), unstimulated SMSL (r = 0.14, p < 0.0001), and stimulated SMSL (r = 0.16, p < 0.003). When adjusted for age and gender, the partial correlations between bite force and salivary flow rates remained significant for unstimulated whole saliva (r = 0.10, p < 0.05), stimulated parotid saliva (r = 0.13, p < 0.02), and stimulated SMSL saliva (r = 0.14, p < 0.006). Subjects were divided into four groups based on their maximal bite force score (low, medium low, medium high, and high). For each saliva type, the flow rate of the high-bite-force group was significantly greater than that of the low-bite-force group as well as that of the medium-high-bite-force group. These results confirm an age-related decrease in bite force and salivary flow rates and show that, regardless of age or gender, bite force is correlated with salivary flow. C1 Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci 7919, Sch Dent, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Community Dent, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Orthodont, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Yeh, CK (reprint author), Univ Texas, Hlth Sci Ctr, Dept Dent Diagnost Sci 7919, Sch Dent, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 66 TC 57 Z9 60 U1 1 U2 3 PU AMER ASSOC DENTAL RESEARCH PI ALEXANDRIA PA 1619 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0022-0345 J9 J DENT RES JI J. Dent. Res. PD AUG PY 2000 VL 79 IS 8 BP 1560 EP 1565 PG 6 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 359GU UT WOS:000089603800006 PM 11023275 ER PT J AU Asch, S Connor, SE Hamilton, EG Fox, SA AF Asch, S Connor, SE Hamilton, EG Fox, SA TI Problems in recruiting community-based physicians for health services research SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Review DE physician recruitment methods; health services research ID MAIL SURVEYS; RANDOMIZED TRIAL; RESPONSE RATES; OBSTETRIC CARE; PRACTITIONERS; PREVENTION; WOMEN AB OBJECTIVE: To qualitatively determine factors that are associated with higher participation rates in community-based health services research requiring significant physician participation burden. MEASUREMENTS: A review of the literature was undertaken using medline and the Social Science Research Index to identify health services research studies that recruited large community-based samples of individual physicians and in which the participation burden exceeded that of merely completing a survey. Two reviewers abstracted data on the recruitment methods, and first authors were contacted to supplement published information. MAIN RESULTS: Sixteen studies were identified with participation rates from 2.5% to 91%. Almost all studies used physician recruiters to personally contact potential participants. Recruiters often knew some of the physicians to be recruited, and personal contact with these "known" physicians resulted in greater participation rates. Incentives were generally absent or modest, and at modest levels, did not appear to affect participation rates. Investigators were almost always affiliated with academic institutions, but were divided as to whether this helped or hindered recruitment. HMO-based and minority physicians were more difficult to recruit. Potential participants most often cited time pressures on staff and themselves as the study burden that caused them to decline. CONCLUSIONS: Physician personal contact and friendship networks are powerful tools for recruitment. Participation rates might improve by including HMO and minority physicians in the recruitment process. Investigators should transfer as much of the study burden from participating physicians to project staff as possible. C1 RAND Corp, Santa Monica, CA 90407 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. PacifiCare Behav Hlth, Van Nuys, CA USA. RP Asch, S (reprint author), RAND Corp, 1700 Main St,POB 2138, Santa Monica, CA 90407 USA. FU NCI NIH HHS [1 RO1 CA65879] NR 25 TC 89 Z9 89 U1 2 U2 10 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2000 VL 15 IS 8 BP 591 EP 599 DI 10.1046/j.1525-1497.2000.02329.x PG 9 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 349PF UT WOS:000089054300010 PM 10940152 ER PT J AU Lim, GP Yang, F Chu, T Chen, P Beech, W Teter, B Tran, T Ubeda, O Ashe, KH Frautschy, SA Cole, GM AF Lim, GP Yang, F Chu, T Chen, P Beech, W Teter, B Tran, T Ubeda, O Ashe, KH Frautschy, SA Cole, GM TI Ibuprofen suppresses plaque pathology and inflammation in a mouse model for Alzheimer's disease SO JOURNAL OF NEUROSCIENCE LA English DT Article DE inflammation; cytokines; microglia; amyloid; Alzheimer; NSAID ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; TRANSGENIC MICE; AMYLOID PLAQUES; RECEPTOR-GAMMA; MICROGLIA; CYTOKINE; PATHOGENESIS; BRAINS; RISK AB The brain in Alzheimer's disease (AD) shows a chronic inflammatory response characterized by activated glial cells and increased expression of cytokines and complement factors surrounding amyloid deposits. Several epidemiological studies have demonstrated a reduced risk for AD in patients using nonsteroidal anti-inflammatory drugs (NSAIDs), prompting further inquiries about how NSAIDs might influence the development of AD pathology and inflammation in the CNS. We tested the impact of chronic orally administered ibuprofen, the most commonly used NSAID, in a transgenic model of AD displaying widespread microglial activation, age-related amyloid deposits, and dystrophic neurites. These mice were created by overexpressing a variant of the amyloid precursor protein found in familial AD. Transgene-positive (Tg+) and negative (Tg-) mice began receiving chow containing 375 ppm ibuprofen at 10 months of age, when amyloid plaques first appear, and were fed continuously for 6 months. This treatment produced significant reductions in final interleukin-1 beta and glial fibrillary acidic protein levels, as well as a significant diminution in the ultimate number and total area of beta-amyloid deposits. Reductions in amyloid deposition were supported by ELISA measurements showing significantly decreased SDS-insoluble A beta. Ibuprofen also decreased the numbers of ubiquitin-labeled dystrophic neurites and the percentage area per plaque of antiphosphotyrosine-labeled microglia. Thus, the anti-inflammatory drug ibuprofen, which has been associated with reduced AD risk in human epidemiological studies, can significantly delay some forms of AD pathology, including amyloid deposition, when administered early in the disease course of a transgenic mouse model of AD. C1 Univ Calif Los Angeles, Dept Med & Neurol SFVP, Sepulveda VAMC GRECC 11E, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Sepulveda, CA 91343 USA. Univ Minnesota, Dept Neurol, Ctr Clin & Mol Neurobiol, Minneapolis, MN 55455 USA. Univ Minnesota, Dept Neurosci, Minneapolis, MN 55455 USA. RP Cole, GM (reprint author), Univ Calif Los Angeles, Dept Med & Neurol SFVP, Sepulveda VAMC GRECC 11E, 16111 Plummer St, Sepulveda, CA 91343 USA. FU NCCIH NIH HHS [R01 AT003008]; NIA NIH HHS [AG13471, AG15453, P50 AG016570, R01 AG010685, R01 AG013741] NR 34 TC 641 Z9 668 U1 4 U2 50 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD AUG 1 PY 2000 VL 20 IS 15 BP 5709 EP 5714 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 337JM UT WOS:000088354000022 PM 10908610 ER PT J AU Casarett, DJ Karlawish, JHT AF Casarett, DJ Karlawish, JHT TI Are special ethical guidelines needed for palliative care research? SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article DE informed consent; research ethics; human subjects; medical ethics; terminal illness ID INTRACTABLE CANCER PAIN; CLINICAL RESEARCH; INFORMED CONSENT; TERMINAL CANCER; FAMILY MEMBERS; HEALTH-STATUS; LEGAL ISSUES; MANAGEMENT; PERCEPTIONS; TRIAL AB Recent studies have made it clear that there are substantial opportunities to improve end-of-life care. Doing so will,require solid evidence on which to base clinical and polity decisions and this, in turn, will require a focused research effort. However, research that involves patients near the end of life creates numerous ethical challenges. Moreover the inclusion of dying patients in research may make many providers uncomfortable. In short, there seems to he something ethically unique, and uniquely challenging, about palliative care research. This paper considers 4 arguments for this unique status: 1) dying patients are eapecially vulnerable; 2) adequate informed consent may be difficult to obtain; 3) balancing research and clinical roles is particularly difficult; and 4) the risks and benefits of palliative research are difficult to assess. We conclude that the first three of these arguments are weak;, and that special guidelines are not needed. We suggest, however that the fourth argument may have some merit, and should be the focus of discussion among investigators, providers, and patients. (C) U.S. Cancer Pain Relief Committee, 2000. C1 Univ Penn, Ctr Bioeth, Inst Aging, Philadelphia, PA 19104 USA. Univ Penn, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Div Geriatr Med, Philadelphia, PA 19104 USA. Univ Penn, Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Alzheimers Dis Res Ctr, Philadelphia, PA 19104 USA. RP Casarett, DJ (reprint author), Univ Penn, Ctr Bioeth, Inst Aging, 3615 Chestnut St, Philadelphia, PA 19104 USA. FU NIA NIH HHS [1K01AG00931-01] NR 75 TC 69 Z9 69 U1 2 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0885-3924 J9 J PAIN SYMPTOM MANAG JI J. Pain Symptom Manage. PD AUG PY 2000 VL 20 IS 2 BP 130 EP 139 DI 10.1016/S0885-3924(00)00164-0 PG 10 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 351UY UT WOS:000089177600008 PM 10989251 ER PT J AU Clark, RSB Kochanek, PM Adelson, PD Bell, MJ Carcillo, JA Chen, M Wisniewski, SR Janesko, K Whalen, MJ Graham, SH AF Clark, RSB Kochanek, PM Adelson, PD Bell, MJ Carcillo, JA Chen, M Wisniewski, SR Janesko, K Whalen, MJ Graham, SH TI Increases in bcl-2 protein in cerebrospinal fluid and evidence for programmed cell death in infants and children after severe traumatic brain injury SO JOURNAL OF PEDIATRICS LA English DT Article ID SEVERE HEAD-INJURY; BCL-2-DEFICIENT MICE; REGULATING APOPTOSIS; NEURONAL APOPTOSIS; CYTOCHROME-C; EXPRESSION; BAX; SURVIVAL; RAT; OVEREXPRESSION AB Objectives: To determine whether bcl-2, a protein that inhibits apoptosis, would be increased in cerebrospinal fluid (CSF) in infants and children after traumatic brain injury (TBI) and to examine the association of bcl-2 concentration with clinical variables. Study design: Bcl-2 was measured in CSF from 23 children (aged 2 months-16 years) with severe TBI and from 19 children without TBI or meningitis (control subjects) by enzyme-linked immunosorbent assay CSF oligonucleosome concentration was also determined as a marker of DNA degradation. Brain samples from 2 patients undergoing emergent decompressive craniectomies were analyzed for bcl-2 with Western blot and for DNA fragmentation with TUNEL (terminal deoxynucleotidyl-transerase mediated biotin-dUTP nick-end labeling). Results: CSF bcl-2 concentrations were increased in patients with TBI versus control subjects (P = .01). Bcl-2 was increased in patients with TBI who survived versus those who died (P = .02). CSF oligonucleosome concentration tended to be increased after TBI (P = .07) and was not associated with bcl-2. Brain tissue samples showed an increase in bcl-2 in patients with TBI versus adult brain bank control samples and evidence of DNA fragmentation within cells with apoptotic morphology Conclusions: Bcl-2 may participate in the regulation of cell, death after TBI in infants and children. The increase in bcl-2 seen in patients who survived is consistent with a protective role for this anti-apoptotic protein after TBI. C1 Childrens Hosp Pittsburgh, Div Pediat Crit Care, Dept Anesthesiol & Crit Care Med, Pittsburgh, PA 15213 USA. Childrens Hosp Pittsburgh, Dept Pediat, Pittsburgh, PA 15213 USA. Childrens Hosp Pittsburgh, Dept Neurol Surg, Pittsburgh, PA 15213 USA. Childrens Hosp Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15213 USA. Childrens Hosp Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Safar Ctr Resuscitat Res, Pittsburgh, PA USA. VA Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Clark, RSB (reprint author), Childrens Hosp Pittsburgh, Div Pediat Crit Care, Dept Anesthesiol & Crit Care Med, 3705 5th Ave, Pittsburgh, PA 15213 USA. RI ; Kochanek, Patrick/D-2371-2015 OI Wisniewski, Stephen/0000-0002-3877-9860; Kochanek, Patrick/0000-0002-2627-913X FU NICHD NIH HHS [5P30 HD28836]; NINDS NIH HHS [KO8 NS01946, R01 NS38620] NR 48 TC 66 Z9 69 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-3476 EI 1097-6833 J9 J PEDIATR-US JI J. Pediatr. PD AUG PY 2000 VL 137 IS 2 BP 197 EP 204 DI 10.1067/mpd.2000.106903 PG 8 WC Pediatrics SC Pediatrics GA 345TZ UT WOS:000088832400013 PM 10931412 ER PT J AU Schwartz, Z Weesner, T van Dijk, S Cochran, DL Mellonig, JT Lohmann, CH Carnes, DL Goldstein, M Dean, DD Boyan, BD AF Schwartz, Z Weesner, T van Dijk, S Cochran, DL Mellonig, JT Lohmann, CH Carnes, DL Goldstein, M Dean, DD Boyan, BD TI Ability of deproteinized cancellous bovine bone to induce new bone formation SO JOURNAL OF PERIODONTOLOGY LA English DT Article DE bone; deproteinized; bone regeneration; osteogenesis ID FREEZE-DRIED BONE; GROWTH FACTOR-BETA; MORPHOGENETIC PROTEIN; POLYACRYLAMIDE GELS; ALLOGRAFT; MATRIX; IMPLANTS; DEFECTS; HYDROXYAPATITE; AUGMENTATION AB Background: Preclinical and clinical studies indicate that deproteinized cancellous bovine bone is osteoconductive and may be osteopromotive. Previous studies using commercial preparations failed to demonstrate the presence of protein, implicating bone-mineral composition and 3-dimensional structure as reasons for clinical success; however, these studies did not examine whether osteoinductive factors might be present in close association with the mineral phase. Methods: Deproteinized cancellous bovine bone was decalcified and any protein present released by chaotropic solvents using the protocol described for purification of bone morphogenetic proteins (BMPs). Three extracts were obtained and tested for their ability to support osteoinduction in the calf muscle of nude mice. Results: Protein content averaged 11 mug/g based on absorbance at 280 nm using bovine serum albumin as a standard. All extracts contained material that stained positively with silver stain after sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS PAGE). Western blots of these gels indicated the presence of transforming growth factor-beta (TGF-beta) and BMP-2, All 3 extracts were osteoinductive in the nude mouse model when combined with inactive DFDBA, and bone formation was comparable to that induced by active DFDBA, Deproteinized cancellous bovine bone by itself was not osteoinductive in the nude mouse, but in a clinical case, exhibited osteoclastic resorption with adjacent new bone formation. Conclusions: The results suggest that small amounts of protein are present in deproteinized cancellous bovine bone in close association with the mineral phase, Some of the extracted material has osteoinductive potential and may contain growth factors, This may explain the osteopromotive ability of deproteinized cancellous bovine bone clinically. C1 Univ Texas, Hlth Sci Ctr, Dept Orthopaed, San Antonio, TX 78229 USA. Hebrew Univ Jerusalem, Hadassah Fac Dent Med, Dept Periodont, Jerusalem, Israel. Univ Texas, Hlth Sci Ctr, Dept Periodont, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Hosp, San Antonio, TX 78284 USA. Univ Gottingen, Dept Orthopaed, D-3400 Gottingen, Germany. Univ Texas, Dept Biochem, San Antonio, TX 78285 USA. RP Boyan, BD (reprint author), Univ Texas, Hlth Sci Ctr, Dept Orthopaed, Mail Code 7774,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. OI Dean, David/0000-0002-4512-9065 NR 64 TC 91 Z9 94 U1 0 U2 3 PU AMER ACAD PERIODONTOLOGY PI CHICAGO PA 737 NORTH MICHIGAN AVENUE, SUITE 800, CHICAGO, IL 60611-2690 USA SN 0022-3492 J9 J PERIODONTOL JI J. Periodont. PD AUG PY 2000 VL 71 IS 8 BP 1258 EP 1269 DI 10.1902/jop.2000.71.8.1258 PG 12 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 411GL UT WOS:000167489800006 PM 10972641 ER PT J AU Pando, JA Duray, P Yarboro, C Gourley, MF Klippel, JH Schumacher, HR AF Pando, JA Duray, P Yarboro, C Gourley, MF Klippel, JH Schumacher, HR TI Synovitis occurs in some clinically normal and asymptomatic joints in patients with early arthritis SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE rheumatoid arthritis; reactive arthritis; synovitis; knee ID RHEUMATOID-ARTHRITIS; CHLAMYDIA-TRACHOMATIS; TISSUE; DNA AB Objective. To determine if clinically asymptomatic knee joints in patients with recent onset arthritis reveal histological evidence of synovitis. Methods, As part of a prospective study of patients with synovitis of less than one year duration, we performed blind needle biopsies on the knees of 20 patients who had synovitis elsewhere but no symptoms or detectable swelling or tenderness of the biopsied joint. Results, Histologic evidence of synovitis was observed in 11 knees (55%). All patients with synovitis had evidence of synovial lining cell hyperplasia, increased vascularity, and lymphocytic infiltrates. Five of 6 patients with rheumatoid arthritis (RA) and 5 of 8 with undifferentiated arthritis had histological evidence of synovitis. but none of the 5 with reactive arthritis (ReA) had synovitis in the asymptomatic joints. Histologic evidence of synovitis persisted in some after clinical resolution of previous pain and swelling, while it occurred in others with no history of previous involvement of that knee. Conclusion. Even asymptomatic joints in patients with RA and undifferentiated arthritis of recent onset reveal histologic signs of synovitis. The earliest changes may occur before symptoms. Histologic changes also persist after resolution of previous early symptoms. Evidence of inflammation was not present in asymptomatic joints in our 5 patients diagnosed with ReA. C1 NIAMS, Arthrit & Rheumatism Branch, NIH, Bethesda, MD USA. NCI, Pathol Lab, NIH, Bethesda, MD 20892 USA. Univ Penn, Div Rheumatol, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Pando, JA (reprint author), 1305 Savannah Rd, Lewes, DE 19951 USA. NR 23 TC 29 Z9 30 U1 0 U2 1 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD AUG PY 2000 VL 27 IS 8 BP 1848 EP 1854 PG 7 WC Rheumatology SC Rheumatology GA 340PM UT WOS:000088543500007 PM 10955323 ER PT J AU Xue, L Shireman, PK Hampton, B Burgess, WH Greisler, HP AF Xue, L Shireman, PK Hampton, B Burgess, WH Greisler, HP TI The cysteine-free fibroblast growth factor 1 mutant induces heparin-independent proliferation of endothelial cells and smooth muscle cells SO JOURNAL OF SURGICAL RESEARCH LA English DT Article DE fibroblast growth factor 1; fibrin glue; thrombin; endothelial cells; smooth muscle cells ID INTIMAL HYPERPLASIA; FACTOR TYPE-1; FACTOR-I; BINDING; RESIDUES; RELEASE; INJURY; RAT AB Background. The structure/function relationships of fibroblast growth factor 1 (FGF-1) are being investigated using site mutation, yielding novel structures with potential clinical applicability for modulating tissue responses to vascular interventions. We generated a mutant FGF-1 in which all three cysteines were converted to serines and then tested the relative mitogenic activities on endothelial cells (ECs) and smooth muscle cells (SMCs) and the molecular stability of the protein to thrombin-induced degradation. Methods. The dose responses of wild-type FGF-1 and the Cys-free mutant in the absence or presence of heparin were tested on ECs and SMCs, Cell proliferation was measured by [H-3]thymidine incorporation. Data were normalized by positive control (20% fetal bovine serum) and expressed as percentage of positive control for comparison. The molecular stability was examined by exposure of the cytokines to thrombin at 37 degrees C for 0.5-24 h and then analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, Results. Unlike wild-type FGF-1 which induced only minimal DNA synthesis at concentrations as high as 100 ng/ml, the Cys-free mutant induced a dose-dependent proliferation starting at 1 ng/ml on both ECs and SMCs in the absence of heparin, At 100 ng/ml, Cys-free mutant induced 4-fold more proliferation than wild-type FGF-1 on ECs (76.64 +/- 13.39% vs 14.58 +/- 1.38%, P < 0.01) and 12-fold more proliferation on SMCs (143.52 +/- 9.96 vs 11.25 +/- 3.32, P < 0.01). Heparin 5 U/ml potentiated the mitogenic activity of the Cys-free mutant at low dose range. Both proteins were degraded by thrombin progressively. But the Cys-free mutant showed more susceptibility with accelerated appearance of lower-molecular-weight fragment bands after incubation with thrombin, Conclusions. Conversion of cysteine residues to serine changed the heparin dependency of the growth factor and increased its mitogenic activity and its susceptibility to thrombin-induced degradation. (C) 2000 Academic Press. C1 Loyola Univ, Med Ctr, Dept Surg, Maywood, IL 60153 USA. Loyola Univ, Med Ctr, Dept Cell Biol Neurobiol & Anat, Maywood, IL 60153 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Dept Surg, Hines, IL 60141 USA. Amer Red Cross, Jerome H Holland Lab, Dept Tissue Biol, Rockville, MD USA. RP Greisler, HP (reprint author), Loyola Univ, Med Ctr, Dept Surg, 2160 S 1st Ave, Maywood, IL 60153 USA. RI Hampton, Brian/G-8427-2015 OI Hampton, Brian/0000-0003-4650-2869 FU PHS HHS [R01-41272] NR 21 TC 13 Z9 14 U1 0 U2 0 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0022-4804 J9 J SURG RES JI J. Surg. Res. PD AUG PY 2000 VL 92 IS 2 BP 255 EP 260 DI 10.1006/jsre.2000.5945 PG 6 WC Surgery SC Surgery GA 339RA UT WOS:000088490700018 PM 10896831 ER PT J AU Friedlander, AH Walker, LA Friedlander, IK Felsenfeld, AL AF Friedlander, AH Walker, LA Friedlander, IK Felsenfeld, AL TI Diagnosing and comanaging patients with obstructive sleep apnea syndrome SO JOURNAL OF THE AMERICAN DENTAL ASSOCIATION LA English DT Article ID MAXILLOMANDIBULAR ADVANCEMENT SURGERY; MANDIBULAR ADVANCEMENT; SURGICAL-MANAGEMENT; HYPOPNEA SYNDROME; ORAL APPLIANCE; UPPER AIRWAY; RISK; PREVALENCE; ATHEROMAS; EFFICACY AB Background, Obstructive sleep apnea syndrome, or OSAS, is a common, but underdiagnosed, disorder that potentially is fatal. It is characterized by repetitive episodes of complete or partial upper airway obstruction leading to absent or diminished : airflow into the lungs. These episodes usually last 10 to 30 seconds and result in loud snoring, a decrease in oxygen saturation, and chronic daytime sleepiness and fatigue. The obstruction is caused by the soft palate, base of the tongue or both collapsing against the pharyngeal walls because of decreased muscle tone during sleep. Potentially fatal systemic illnesses frequently associated with this disorder include hypertension, pulmonary hypertension, heart failure, nocturnal cardiac dysrhythmias, myocardial infarction and ischemic stroke. Clinical Implications, The classic signs and symptoms of OSAS may be recognizable by dental. practitioners. Common findings in the medical history include daytime sleepiness, snoring, hypertension and type 2 diabetes mellitus. Common clinical findings include obesity; a thick neck; excessive fat deposition in the palate, tongue (enlarged) and pharynx; a long soft palate; a retrognathic mandible; and calcified carotid artery atheromas on panoramic and lateral cephalometric radiographs. Conclusions, Dentists cognizant of these signs and symptoms have an opportunity to diagnose patients with occult OSAS. After confirmation of the diagnosis by a physician, dentists can participate in management of the disorder by fabricating mandibular advancement appliances and performing surgical procedures that prevent recurrent airway obstruction. C1 Vet Affairs Outpatient Clin & Nursing Home, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. W Valley Los Angeles Cty Dept Hlth, Panorama City, CA USA. RP Friedlander, AH (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 43 TC 11 Z9 15 U1 0 U2 0 PU AMER DENTAL ASSN PI CHICAGO PA 211 E CHICAGO AVE, CHICAGO, IL 60611 USA SN 0002-8177 J9 J AM DENT ASSOC JI J. Am. Dent. Assoc. PD AUG PY 2000 VL 131 IS 8 BP 1178 EP 1184 PG 7 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 355LR UT WOS:000089387600031 PM 10953534 ER PT J AU Braun, U Kunik, M Stanley, M Stoebner, D Molinari, V Wristers, K Teasdale, T AF Braun, U Kunik, M Stanley, M Stoebner, D Molinari, V Wristers, K Teasdale, T TI A brief cognitive behavioral intervention to improve functioning in elderly patients with chronic obstructive pulmonary disease (COPD) SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract C1 Baylor Coll Med, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. Gerontol Soc Amer, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD AUG PY 2000 VL 48 IS 8 MA P61 BP S26 EP S26 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 346TK UT WOS:000088887000129 ER PT J AU Cognetti, D Alessi, C Newman, AB Schnelle, J AF Cognetti, D Alessi, C Newman, AB Schnelle, J TI Social interaction and sleep in nursing home residents SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract C1 Univ Calif Los Angeles, Los Angeles, CA USA. Greater Los Angeles Vet Adm Healthcare Syst, Sepulveda, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD AUG PY 2000 VL 48 IS 8 MA P144 BP S47 EP S47 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 346TK UT WOS:000088887000210 ER PT J AU Grimes, A Mccullough, L Kunik, M Molinari, V Workman, R AF Grimes, A Mccullough, L Kunik, M Molinari, V Workman, R TI Informed consent across psychiatric disorders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract C1 Baylor Coll Med, Gerontol Soc Amer, Houston, TX 77030 USA. Houston VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD AUG PY 2000 VL 48 IS 8 MA P452 BP S121 EP S121 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 346TK UT WOS:000088887000508 ER PT J AU Kim, EC Alessi, C Schnelle, J AF Kim, EC Alessi, C Schnelle, J TI Circadian rhythms of activity and sleep/wake in demented NH residents. SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Meeting Abstract C1 Univ Calif Los Angeles, Los Angeles, CA USA. Greater Los Angeles VA Healthcare Syst, Sepulveda, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD AUG PY 2000 VL 48 IS 8 MA P150 BP S48 EP S48 PG 1 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 346TK UT WOS:000088887000216 ER PT J AU Marcelli, M Shao, TC Li, XY Yin, H Marani, M Denner, L Teng, B Cunningham, GR AF Marcelli, M Shao, TC Li, XY Yin, H Marani, M Denner, L Teng, B Cunningham, GR TI Induction of apoptosis in BPH stromal cells by adenoviral-mediated overexpression of caspase-7 SO JOURNAL OF UROLOGY LA English DT Article DE benign prostate hyperplasia; apoptosis; caspases ID BENIGN PROSTATIC HYPERPLASIA; TRANSGENIC MICE; GRANZYME-B; GENE; DEATH; EXPRESSION; PROTEASE; FAMILY; CANCER AB Purpose: We hypothesized that expression/activity of critical components of the apoptotic pathway can be used to induce apoptosis of a human prostate cell line derived from benign prostatic hyperplasia (BPH) tissue. Materials and Methods: We analyzed the apoptotic pathway in BPH, cells treated with the powerful inducer of apoptosis, staurosporine (STS), and adenoviruses overexpressing caspase-3, -7, or the control gene lacZ. Results: Twelve hours post-STS, most BPH cells were floating in the culture medium, TUNEL staining was widespread, and DEVDase activity (the catalytic activity of type II caspases) was increased. The pan-caspase inhibitor, Z-VAD-FMK, prevented STS-induced apoptosis, Based on these observations, we performed immunoblot analysis for the three known group II caspases (that is caspase-2, -3 and -7), but none of them was detected with three commercially available antibodies. Nevertheless, in view of the presence of increased DEVDase activity, we reasoned that a group II caspase must be a critical mediator of apoptosis in this model. If correct, we postulated that overexpression and activation of a type II caspase should cause apoptosis. To test this hypothesis, we coupled the cDNAs encoding caspase-3 and caspase-7 to adenoviral vectors and obtained constructs AvC3 and AvC7. Cells infected with AvC3 or AVC7 overexpressed the protein for caspase-3 or -7 within 24 to 48 hours. Caspase-3 overexpression did not cause apoptosis above that observed in cells receiving the control adenovirus expressing the lacZ cDNA (AvLac-Z). In contrast, caspase-7 overexpression induced massive apoptosis, BPH cells were then infected with increasing multiplicity of infection (MOI) of AvC7 and AvlacZ. A positive correlation was found between the amount of caspase-7 expressed and the level of DEVDase activity measured. AVC7 at MOIs of 25:1 and 50:1 induced apoptosis in about 50% of BPH cells at; 72 hours post-infection. This effect was AVC7 specific, because the same MOIs of AvlacZ were not apoptogenic. Conclusions: Adenoviral-mediated overexpression of caspase-7 induces apoptosis of BPH-derived cells. C1 Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Texas Biotechnol Corp, VA Med Ctr, Dept Cell Biol, Houston, TX USA. Univ Texas, Hlth Sci Ctr, Inst Mol Med, Houston, TX USA. RP Cunningham, GR (reprint author), 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 35 TC 15 Z9 18 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD AUG PY 2000 VL 164 IS 2 BP 518 EP 525 DI 10.1016/S0022-5347(05)67416-2 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 333JB UT WOS:000088126200087 PM 10893637 ER PT J AU Szurek, PF Brooks, BR AF Szurek, PF Brooks, BR TI Synthesis of virus-specific high-mobility DNA after temperature upshift of SC-1 cells chronically infected with moloney murine leukemia virus mutant ts1 SO JOURNAL OF VIROLOGY LA English DT Article ID TS1-INDUCED SPONGIFORM ENCEPHALOMYELOPATHY; RETROVIRAL DNA; REVERSE TRANSCRIPTION; TYPE-1 REPLICATION; TRIPHOSPHATE POOLS; PHYSICAL FORMS; PARALYZED MICE; HOST-RANGE; 3T3 CELLS; INTEGRATION AB Premature termination products of reverse transcription that consist physically of viral minus-sense single-stranded DNA that is shorter than one long terminal repeat and partial DNA duplexes are dramatically increased in the central nervous system (CNS) of FVB/N mice that are infected by ts1, a temperature-sensitive mutant of Moloney murine leukemia virus. Due to their migration in agarose gels, these incomplete physical forms of DNA have been designated high-mobility (HM) DNA, In non-CNS tissues, the level of HM DNA is either low or not detectable. In order to determine the conditions that are necessary for the synthesis of HM DNA in vivo, we have characterized the physical forms of HM DNA that were synthesized in vitro in chronically infected SC-1 cells after temperature upshift, At the permissive temperature of 34 degrees C, the chronically infected SC-1 cells did not synthesize HM DNA. After temperature upshift of the cultured cells from 34 to 37 degrees C, the chronically infected SC-1 cells developed extremely high levels of HM DNA, Following temperature downshift of the cultured cells from 37 to 34 degrees C, a decrease in the level of HM DNA and an increase in the level of unintegrated linear proviral DNA occurred simultaneously. These results suggested that the accumulation of HM DNA both in vitro and in vivo may be the result of superinfection. C1 William S Middleton Mem Vet Hosp, Neurol & Res Serv, Madison, WI 53705 USA. Univ Wisconsin, Madison Med Sch, Dept Neurol, Madison, WI 53705 USA. Univ Wisconsin, Madison Med Sch, Dept Med Microbiol, Madison, WI 53705 USA. RP Brooks, BR (reprint author), William S Middleton Mem Vet Hosp, Neurol & Res Serv, Room B6112,2500 Overlook Terrace, Madison, WI 53705 USA. NR 46 TC 1 Z9 1 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD AUG PY 2000 VL 74 IS 15 BP 7055 EP 7063 DI 10.1128/JVI.74.15.7055-7063.2000 PG 9 WC Virology SC Virology GA 333AE UT WOS:000088105900039 PM 10888645 ER PT J AU Riddle, JR Hyams, KC Murphy, FM Mazzuchi, JF AF Riddle, JR Hyams, KC Murphy, FM Mazzuchi, JF TI In the borderland between health and disease following the Gulf War SO MAYO CLINIC PROCEEDINGS LA English DT Editorial Material ID VETERANS C1 US Dept Def, Washington, DC USA. USN, Med Res Ctr, Bethesda, MD 20084 USA. US Dept Vet Affairs, Washington, DC USA. RP Riddle, JR (reprint author), USAF, BSC, Skyline 5,Suite 810 Mail,5111 Leesburg Pike, Falls Church, VA 22041 USA. NR 22 TC 7 Z9 7 U1 0 U2 1 PU MAYO CLINIC PROCEEDINGS PI ROCHESTER PA 660 SIEBENS BLDG MAYO CLINIC, ROCHESTER, MN 55905 USA SN 0025-6196 J9 MAYO CLIN PROC JI Mayo Clin. Proc. PD AUG PY 2000 VL 75 IS 8 BP 777 EP 779 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 341UE UT WOS:000088607400001 PM 10943228 ER PT J AU Geraci, JM AF Geraci, JM TI In-hospital complication occurrence as a screen for quality-of-care problems - What's next? SO MEDICAL CARE LA English DT Editorial Material ID ADVERSE EVENTS; IDENTIFYING COMPLICATIONS; ADMINISTRATIVE DATA; RISK C1 Houston VAMC, Houston, TX 77030 USA. RP Geraci, JM (reprint author), Houston VAMC, 111C,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 22 TC 5 Z9 5 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD AUG PY 2000 VL 38 IS 8 BP 777 EP 780 DI 10.1097/00005650-200008000-00001 PG 4 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 337ZP UT WOS:000088393900001 PM 10929989 ER PT J AU Spyropoulos, DD Pharr, PN Lavenburg, KR Jackers, P Papas, TS Ogawa, M Watson, DK AF Spyropoulos, DD Pharr, PN Lavenburg, KR Jackers, P Papas, TS Ogawa, M Watson, DK TI Hemorrhage, impaired hematopoiesis, and lethality in mouse embryos carrying a targeted disruption of the Fli1 transcription factor SO MOLECULAR AND CELLULAR BIOLOGY LA English DT Article ID MEGAKARYOCYTE-SPECIFIC EXPRESSION; GLYCOPROTEIN-IX PROMOTER; ETS FAMILY; DNA-BINDING; MURINE LEUKEMIA; GENE-EXPRESSION; TRANSGENIC MICE; PROTEINS; GATA; ERYTHROLEUKEMIA AB The Ets family of transcription factors have been suggested to function as key regulators of hematopoeisis. sere we describe aberrant hematopoeisis and hemorrhaging in mouse embryos homozygous for a targeted disruption in the Ets family member, Fli1. Mutant embryos are found to hemorrhage from the dorsal aorta to the lumen of the neural tube and ventricles of the brain (hematorrhachis) on embryonic day 11.0 (E11.0) and are dead by E12.5. Histological examinations and in situ hybridization reveal disorganization of columnar epithelium and the presence of hematomas within the neuroepithelium and disruption of the basement membrane lying between this and mesenchymal tissues, both of which express Fli1 at the time of hemorrhaging. Livers from mutant embryos contain few pronormoblasts and basophilic normoblasts and have drastically reduced numbers of colony forming cells. These defects occur with complete penetrance of phenotype regardless of the genetic background (inbred B6, hybrid 129/B6, or outbred CD1) or the targeted embryonic stem cell line used for the generation of knockout lines. Taken together, these results provide in vivo evidence for the role of Fli1 in the regulation of hematopoiesis and hemostasis. C1 Med Univ S Carolina, Hollings Canc Ctr, Ctr Mol & Struct Biol, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. RP Watson, DK (reprint author), Med Univ S Carolina, Hollings Canc Ctr, Ctr Mol & Struct Biol, Charleston, SC 29425 USA. FU NCI NIH HHS [P01 CA078582, P01 CA78582] NR 42 TC 207 Z9 208 U1 0 U2 3 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0270-7306 J9 MOL CELL BIOL JI Mol. Cell. Biol. PD AUG PY 2000 VL 20 IS 15 BP 5643 EP 5652 DI 10.1128/MCB.20.15.5643-5652.2000 PG 10 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 334LX UT WOS:000088188900025 PM 10891501 ER PT J AU Tyagi, RK Lavrovsky, Y Ahn, SC Song, CS Chatterjee, B Roy, AK AF Tyagi, RK Lavrovsky, Y Ahn, SC Song, CS Chatterjee, B Roy, AK TI Dynamics of intracellular movement and nucleocytoplasmic recycling of the ligand-activated androgen receptor in living cells SO MOLECULAR ENDOCRINOLOGY LA English DT Article ID GREEN FLUORESCENT PROTEIN; HUMAN ESTROGEN-RECEPTOR; NUCLEAR EXPORT SIGNAL; GLUCOCORTICOID-RECEPTOR; PROGESTERONE-RECEPTOR; SUBCELLULAR-LOCALIZATION; IMMUNOCYTOCHEMICAL LOCALIZATION; TRANSCRIPTIONAL ACTIVATION; MONOCLONAL-ANTIBODIES; PROSTATE-CANCER AB An expression construct containing the cDNA encoding a modified aequorea green fluorescent protein (GFP) ligated to the 5'-end of the rat androgen receptor (AR) cDNA (GFP-AR) was used to study the intracellular dynamics of the receptor movement in living cells. In three different cell lines, be. PC3, HeLa, and COS1, unliganded GFP-AR was seen mostly in the cytoplasm and rapidly (within 15-60 min) moved to the nuclear compartment after androgen treatment. Upon androgen withdrawal, the labeled AR migrated back to the cytoplasmic compartment and maintained its ability to reenter the nucleus on subsequent exposure to androgen. Under the condition of inhibited protein synthesis by cycloheximide (50 mu g/ml), at least four rounds of receptor recycling after androgen treatment and withdrawal were recorded. Two nonandrogenic hormones, 17 beta-estradiol and progesterone at higher concentrations (10(-7)/10(-6) M), were able to both transactivate the AR-responsive promoter and translocate the GFP-AR into the nucleus. Similarly, antiandrogenic ligands, cyproterone acetate and casodex, were also capable of translocating the cytoplasmic AR into the nucleus albeit at a slower rate than the androgen 5 alpha-dihydrotestosterone (DHT). All AR ligands with transactivation potential, including the mixed agonist/antagonist cyproterone acetate, caused translocation of the GFP-AR into a subnuclear compartment indicated by its punctate intranuclear distribution. However, translocation caused by casodex, a pure antagonist, resulted in a homogeneous nuclear distribution. Subsequent exposure of the casodex-treated cell to DHT rapidly (15-30 min) altered the homogeneous to punctate distribution of the already translocated nuclear AR. When transported into the nucleus either by casodex or by DHT, GFP-AR was resistant to 2 M NaCl extraction, indicating that the homogeneously distributed AR is also associated with the nuclear matrix. Taken together, these results demonstrate that AR requires ligand activation for its nuclear translocation where occupancy by only agonists and partial agonists can direct it to a potentially functional subnuclear location and that one receptor molecule can undertake multiple rounds of hormonal signaling; this indicates that ligand dissociation/inactivation rather than receptor degradation may play a critical role in terminating hormone action. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Affairs Hosp, San Antonio, TX 78284 USA. RP Roy, AK (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. EM roy@uthscsa.edu FU NIA NIH HHS [AG-10486]; NIDDK NIH HHS [DK-14744] NR 53 TC 209 Z9 219 U1 0 U2 2 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0888-8809 J9 MOL ENDOCRINOL JI Mol. Endocrinol. PD AUG PY 2000 VL 14 IS 8 BP 1162 EP 1174 DI 10.1210/me.14.8.1162 PG 13 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 339VK UT WOS:000088498400004 PM 10935541 ER PT J AU King, JT AF King, JT TI How many neurosurgeons does it take to write a research article? Authorship proliferation in neurosurgical research SO NEUROSURGERY LA English DT Article DE authorship; bibliometrics; neurosurgery; research ID MULTIPLE AUTHORSHIP; CITATION ANALYSIS; JOURNALS; COAUTHORSHIP; TRENDS; PUBLICATIONS; FREQUENCY; PUBLISH; PERISH; TOOL AB OBJECTIVE: Authorship proliferation in biomedical research has become rampant; the proportion of single-author articles is decreasing, the percentage of multiauthor articles is increasing, and the number of authors per publication is increasing. To determine whether authorship trends in the North American neurosurgical literature parallel trends observed in other areas of the biomedical literature, I studied original neurosurgical research articles published in the past 50 years. METHODS: I sampled clinical, anatomic, and laboratory investigations in Neurosurgery and the Journal of Neurosurgery at 10-year intervals from 1945 to 1995. For each research article, I determined the number of authors, the countries of origin, and the educational degrees of the authors. RESULTS: The mean number of authors per article has increased steadily in the past 50 years, from 1.8 (standard deviation, +/-0.8) authors per article in 1945 to 4.6 (standard deviation, +/-2.1) authors in 1995. The proportion of single-author articles is decreasing; these articles accounted for 43% of articles in 1945 and only 3% of articles in 1995. Increases in the proportions of non-M.D. authors and of articles originating outside the United States were also observed. CONCLUSION: The proliferation of multiauthor articles and the decrease in the proportion of single-author articles in the neurosurgical literature parallel trends observed in many other areas of biomedical research. Possible explanations include larger research teams, variable or absent journal criteria for defining authorship, and the increased awarding of "gift" authorships. C1 Univ Pittsburgh, Dept Neurol Surg, Pittsburgh, PA 15213 USA. VA Pittsburgh Healthcare Syst, Neurosurg Sect, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Serv Res, Pittsburgh, PA USA. Univ Pittsburgh, Ctr Res Hlth Care, Dept Med, Pittsburgh, PA 15213 USA. RP King, JT (reprint author), Univ Pittsburgh, Dept Neurol Surg, 200 Lothrop St,B-400 PUH, Pittsburgh, PA 15213 USA. NR 40 TC 45 Z9 45 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0148-396X J9 NEUROSURGERY JI Neurosurgery PD AUG PY 2000 VL 47 IS 2 BP 435 EP 440 DI 10.1097/00006123-200008000-00032 PG 6 WC Clinical Neurology; Surgery SC Neurosciences & Neurology; Surgery GA 339WZ UT WOS:000088502000085 PM 10942017 ER PT J AU Shalaby, AA Demers, PA Sager, PT Bersohn, MM AF Shalaby, AA Demers, PA Sager, PT Bersohn, MM TI Placement of a defibrillation lead in the left subclavian vein from the right cephalic vein SO PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY LA English DT Article DE defibrillation threshold; ICD implant; active can; left-handed ID IMPLANTATION AB This case report highlights the feasibility and stability of transvenous placement of a second defibrillation lead in the left subclavian vein from a right cephalic vein approach. This was undertaken in a right-sided implant of an active can cardioverter defibrillator to lower defibrillation thresholds that would have otherwise precluded implant. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ Pittsburgh, Pittsburgh, PA USA. ELA Med, Plymouth, MN USA. RP Bersohn, MM (reprint author), Cardiol 111E, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 5 TC 0 Z9 0 U1 0 U2 0 PU FUTURA PUBL CO PI ARMONK PA 135 BEDFORD RD, PO BOX 418, ARMONK, NY 10504-0418 USA SN 0147-8389 J9 PACE JI PACE-Pacing Clin. Electrophysiol. PD AUG PY 2000 VL 23 IS 8 BP 1318 EP 1319 DI 10.1111/j.1540-8159.2000.tb00954.x PG 2 WC Cardiac & Cardiovascular Systems; Engineering, Biomedical SC Cardiovascular System & Cardiology; Engineering GA 343RC UT WOS:000088714500024 PM 10962762 ER PT J AU Brunicardi, FC Dyen, Y Brostrom, Y Kleinman, R Colonna, J Gelabert, H Gingerich, R AF Brunicardi, FC Dyen, Y Brostrom, Y Kleinman, R Colonna, J Gelabert, H Gingerich, R TI The circulating hormonal milieu of the endocrine pancreas in healthy individuals, organ donors, and the isolated perfused human pancreas SO PANCREAS LA English DT Review DE insulin; C-peptide; glucagon; pancreatic polypeptide; glucose; Islet of langerhans ID SPLANCHNIC NEURAL REGULATION; POSTPRANDIAL PLASMA-GLUCOSE; RELEASE-INHIBITING HORMONE; C-PEPTIDE CONCENTRATIONS; INSULIN-SECRETION RATES; GLUCAGON-SECRETION; DIABETES-MELLITUS; GROWTH-HORMONE; ORAL GLUCOSE; SOMATOSTATIN SECRETION AB Although basal circulating levels of individual islet cell hormones have been measured, few studies compared the molar ratios of the major hormones secreted by the endocrine pancreas. This study examined the basal levels of four major islet hormones: insulin, C-peptide (C-P), glucagon (G), and pancreatic polypeptide (PP) in normal subjects, in organ donors with brain death, and in the isolated perfused human pancreas. Basal blood samples were taken from normal, fasted control subjects (NCs). Pancreata were obtained from 17 organ donors (ODs) with donor portal vein (DPV) and radial arterial (DRA) blood samples taken before organ procurement. Single-pass perfusion was performed on the procured pancreata, and after rewarming and equilibration, basal samples were collected from the splenic vein (SV) for 30 min. Radioimmunoassays of insulin, C-P, G, and PP were performed on all samples, and basal levels of all hormones were expressed as a common unit, femtomoles per milliliter. The data suggest that in the basal state, these four major islet hormones circulate in a relatively constant molar ratio. The ratio of the hormones is altered in brain death and with in vitro perfusion of the pancreas. The isolated perfused human pancreas secretes a relatively constant molar ratio of these hormones; however, this ratio is markedly different from the circulating ratio seen in either the NC group or the OD group. We conclude that a relatively constant hormonal milieu is secreted from the normal endocrine pancreas, and this hormonal milieu is altered after brain death and with isolation and perfusion of the human pancreas. C1 Baylor Coll Med, Dept Surg, Houston, TX 77030 USA. W Los Angeles Vet Affairs Med Ctr, Dept Surg, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Surg, Los Angeles, CA 90024 USA. Linco Labs, St Louis, MO USA. RP Brunicardi, FC (reprint author), Baylor Coll Med, Dept Surg, 6550 Fannin,Suite 1625, Houston, TX 77030 USA. FU NIDDK NIH HHS [R29 DK 46441-01] NR 112 TC 9 Z9 9 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0885-3177 J9 PANCREAS JI Pancreas PD AUG PY 2000 VL 21 IS 2 BP 203 EP 211 DI 10.1097/00006676-200008000-00014 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 339VH UT WOS:000088498200014 PM 10975715 ER PT J AU Siegle, GJ Steinhauer, SR AF Siegle, GJ Steinhauer, SR TI Pupillary and reaction-time assessment of interference of emotional and nonemotional information on subsequent processing SO PSYCHOPHYSIOLOGY LA English DT Meeting Abstract C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 USA SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PD AUG PY 2000 VL 37 SU 1 BP S90 EP S90 PG 1 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 364PJ UT WOS:000089900500366 ER PT J AU Siegle, GJ AF Siegle, GJ TI Pupillary and reaction time assessment of attention to emotional information in depression SO PSYCHOPHYSIOLOGY LA English DT Meeting Abstract C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 USA SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PD AUG PY 2000 VL 37 SU 1 BP S15 EP S15 PG 1 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 364PJ UT WOS:000089900500066 ER PT J AU Steinhauer, SR Condray, R Kasparek, A Siegle, GJ AF Steinhauer, SR Condray, R Kasparek, A Siegle, GJ TI Pharmacological dissociation of autonomic pathways contributing to pupillary dilation after motor activity SO PSYCHOPHYSIOLOGY LA English DT Meeting Abstract C1 Univ Pittsburgh, Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 USA SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PD AUG PY 2000 VL 37 SU 1 BP S95 EP S95 PG 1 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 364PJ UT WOS:000089900500385 ER PT J AU Steinhauer, SR Condray, R Kasparek, A AF Steinhauer, SR Condray, R Kasparek, A TI Inhibition of the pupillary light reaction by cognitive activity: Evidence for dual parasympathetic components SO PSYCHOPHYSIOLOGY LA English DT Meeting Abstract C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 USA SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PD AUG PY 2000 VL 37 SU 1 BP S94 EP S94 PG 1 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 364PJ UT WOS:000089900500384 ER PT J AU Steinhauer, SR Condray, R AF Steinhauer, SR Condray, R TI Mechanisms of cognitive modulation in schizophrenia as determined by pupillary motility SO PSYCHOPHYSIOLOGY LA English DT Meeting Abstract C1 Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 USA SN 0048-5772 J9 PSYCHOPHYSIOLOGY JI Psychophysiology PD AUG PY 2000 VL 37 SU 1 BP S15 EP S15 PG 1 WC Psychology, Biological; Neurosciences; Physiology; Psychology; Psychology, Experimental SC Psychology; Neurosciences & Neurology; Physiology GA 364PJ UT WOS:000089900500064 ER PT J AU Percy, LA Fang, MA AF Percy, LA Fang, MA TI Geropharmacology for the rheumatologist SO RHEUMATIC DISEASE CLINICS OF NORTH AMERICA LA English DT Article ID LOW-DOSE METHOTREXATE; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; 2ND-LINE ANTIRHEUMATIC DRUGS; ELDERLY PATIENTS; SERUM CREATININE; CONTROLLED TRIAL; THERAPEUTIC USE; DOUBLE-BLIND; BLOOD-FLOW; ARTHRITIS AB Drug administration to older patients with rheumatic disease is a challenge because they are more likely to have adverse drug reactions compared with younger patients. Elderly patients are at risk for adverse drug effects because they often have multiple acute and chronic illnesses and are on several prescription and over-the-counter medications. This article will enhance the practitioner's understanding of how disease and age modulate the pharmacokinetics and pharmacodynamics of medications commonly prescribed for rheumatic disorders. Minimizing the number of drugs prescribed, starting medications at low doses and increasing slowly, and monitoring for toxicity are especially important in the elderly. With judicious use of medications, the quality of life of older patients with rheumatic disease can be enhanced. C1 Univ Calif San Francisco, Sch Pharm, San Francisco, CA 94143 USA. Univ So Calif, Sch Pharm, Los Angeles, CA USA. Univ Pacific, Sch Pharm, Stockton, CA 95211 USA. Western Univ Hlth Sci, Sch Pharm, Pomona, CA USA. VA Greater Los Angeles Healthcare Syst, Geriatr Pharm Practice Residency, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Ctr Geriatr Res Educ & Clin, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Palliat Treatment Program, Los Angeles, CA USA. RP Percy, LA (reprint author), VA GLAHS, GRECC 11G, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 75 TC 9 Z9 9 U1 1 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0889-857X J9 RHEUM DIS CLIN N AM JI Rheum. Dis. Clin. North Am. PD AUG PY 2000 VL 26 IS 3 BP 433 EP + DI 10.1016/S0889-857X(05)70150-2 PG 24 WC Rheumatology SC Rheumatology GA 350HD UT WOS:000089094200003 PM 10989506 ER PT J AU McCoy, SL Hausman, FA Deffebach, ME Bakke, A Merkens, LS Bennett, RM Hefeneider, SH AF McCoy, SL Hausman, FA Deffebach, ME Bakke, A Merkens, LS Bennett, RM Hefeneider, SH TI Quantification of DNA binding to cell-surfaces by flow cytometry SO JOURNAL OF IMMUNOLOGICAL METHODS LA English DT Article DE flow cytometry; DNA binding; isoparametric analysis ID EPIDERMAL GROWTH-FACTOR; FACTOR RECEPTOR; PLASMID DNA; CPG MOTIFS; QUANTITATION; INVOLVEMENT; MACROPHAGES; TRANSPORT; ANTIGEN; GAMMA AB DNA binding to cell-surfaces has been documented in several studies. The interaction of DNA with cells has been shown to have therapeutic potential as a non-viral form of gene delivery and DNA vaccination. Recently, bacterial DNA binding and internalization has been demonstrated in some cells to trigger secretion of cytokines and cell activation. Previous studies to quantify DNA. binding to cells have used radiolabeled DNA. Here we report a non-radioactive assay for quantification of cell-surface DNA binding based on the isoparametric analysis of flow cytometric data as described by Chatelier et al., Embo J., 5 (1986) 1181. This assay has the advantage over previously used procedures in not employing radioactive material and being able to discriminate viable from non-viable cells that bind DNA. With the importance of understanding the interaction of DNA with cells, this assay may have application for the identification and characterization of reagents designed to either enhance or inhibit DNA binding to cells. (C) 2000 Elsevier Science B.V. All rights reserved. C1 Portland Vet Affairs Med Ctr, Dept Immunol & Pulmonol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Div Med, Portland, OR 97201 USA. Targeted Gene Delivery Inc, Portland, OR USA. RP Hefeneider, SH (reprint author), Portland Vet Affairs Med Ctr, Dept Immunol, 3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. OI Bennett, Robert/0000-0002-7526-3425 FU NCI NIH HHS [R43 CA78140]; NIAMS NIH HHS [R1AR34298]; NIDCD NIH HHS [R01DC03573] NR 23 TC 8 Z9 8 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0022-1759 J9 J IMMUNOL METHODS JI J. Immunol. Methods PD JUL 31 PY 2000 VL 241 IS 1-2 BP 141 EP 146 DI 10.1016/S0022-1759(00)00205-2 PG 6 WC Biochemical Research Methods; Immunology SC Biochemistry & Molecular Biology; Immunology GA 342JJ UT WOS:000088641200013 PM 10915856 ER PT J AU McMahon, FG Fujioka, K Singh, BN Mendel, CM Rowe, E Rolston, K Johnson, F Mooradian, AD AF McMahon, FG Fujioka, K Singh, BN Mendel, CM Rowe, E Rolston, K Johnson, F Mooradian, AD TI Efficacy and safety of sibutramine in obese white and African American patients with hypertension - A 1-year, double-blind, placebo-controlled, multicenter trial SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID CORONARY HEART-DISEASE; DEPENDENT DIABETES-MELLITUS; WEIGHT-LOSS; FOLLOW-UP; CARDIOVASCULAR-DISEASE; REUPTAKE INHIBITOR; ENERGY-EXPENDITURE; INSULIN-RESISTANCE; FAT DISTRIBUTION; UNITED-STATES AB Background: Obesity is a highly prevalent medical condition and is commonly accompanied by hypertension. This study assessed the efficacy and safety of treatment with sibutramine hydrochloride for promoting and maintaining weight loss in obese patients with controlled hypertension, including a subset analysis of African American patients. Patients and Methods: Obese patients with a body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) between 27 and 40 and a history of hypertension controlled with a calcium channel blocker (with or without concomitant thiazide diuretic treatment) were randomized to receive sibutramine (n=150) or placebo (n=74) with minimal behavioral intervention for 52 weeks. African Americans constituted 36% of enrolled patients. Efficacy assessments were body weight and related parameters (BMI and waist and hip circumferences), metabolic parameters (serum levels of triglycerides, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], total cholesterol, glucose, and uric acid), and quality-of-life measures. Safety assessments included recording of blood pressure, pulse rate, adverse events, and reasons for discontinuation. Results: For patients receiving sibutramine, weight loss occurred during the first 6 months of the trial and was maintained to the end of the 12-month treatment period. Among patients receiving sibutramine, 40.1% lost 5% or more of body weight (5% responders) and 13.4% lost 10% or more of body weight (10% responders) compared with 8.7% and 4.3% of patients in the placebo group, respectively (P<.05). Changes in body weight were similar among African Americans and whites. Sibutramine-induced weight loss was associated with significant improvements in serum levels of triglycerides, HDL-C, glucose, and uric acid. Waist circumference and quality-of-life measures also improved significantly in patients receiving sibutramine. Sibutramine-treated patients had small but statistically significant mean increases in diastolic blood pressure (2.0 mm Hg) and pulse rate (4.9 beats/min) compared with placebo-treated patients (-1.3 mm Hg and 0.0 beats/min; P<.05); these changes were similar among African Americans and whites. Most adverse events were mild to moderate in severity and transient. The most common adverse event resulting in discontinuation among patients receiving sibutramine was hypertension (5.3% of patients receiving sibutramine vs 1.4% of patients receiving placebo). Conclusions: In obese patients with controlled hypertension, sibutramine was an effective and well-tolerated treatment for weight loss and maintenance. Sibutramine-induced weight loss resulted in improvements in serum levels of triglycerides, HDL-C, uric acid, and glucose, and in waist circumference and quality-of-life measures. Blood pressure and heart rate increased by a small amount. Efficacy and safety profiles for sibutramine among African American and white obese patients with controlled hypertension were similar. C1 Clin Res Ctr, New Orleans, LA 70112 USA. Scripps Clin, San Jose, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Knoll Pharmaceut Co, Mt Olive, NJ USA. St Louis Univ, Sch Med, Dept Internal Med, Div Endocrinol, St Louis, MO USA. RP McMahon, FG (reprint author), Clin Res Ctr, 147 S Liberty, New Orleans, LA 70112 USA. NR 56 TC 157 Z9 164 U1 0 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JUL 24 PY 2000 VL 160 IS 14 BP 2185 EP 2191 DI 10.1001/archinte.160.14.2185 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 335FM UT WOS:000088233300015 PM 10904462 ER PT J AU Cook, IA Leuchter, AF Witte, E Abrams, M Uijtdehaage, SHJ Stubbeman, W Rosenberg-Thompson, S Anderson-Hanley, C Dunkin, JJ AF Cook, IA Leuchter, AF Witte, E Abrams, M Uijtdehaage, SHJ Stubbeman, W Rosenberg-Thompson, S Anderson-Hanley, C Dunkin, JJ TI Neurophysiologic predictors of treatment response to fluoxetine in major depression (vol 85, pg 263, 1999) SO PSYCHIATRY RESEARCH LA English DT Correction C1 Univ Calif Los Angeles, Sch Med, Neuropsychiat Inst Hosp, Quantitat EEG Lab, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Cook, IA (reprint author), Univ Calif Los Angeles, Sch Med, Neuropsychiat Inst Hosp, Quantitat EEG Lab, 760 Westwood Plaza, Los Angeles, CA 90024 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0165-1781 J9 PSYCHIAT RES JI Psychiatry Res. PD JUL 24 PY 2000 VL 95 IS 1 BP 87 EP 87 DI 10.1016/S0165-1781(00)00170-0 PG 1 WC Psychiatry SC Psychiatry GA 341AP UT WOS:000088569100010 ER PT J AU Friedlander, AH Friedlander, IK Pogrel, MA AF Friedlander, AH Friedlander, IK Pogrel, MA TI Dentistry's role in the diagnosis and co-management of patients with sleep apnoea/hypopnoea syndrome SO BRITISH DENTAL JOURNAL LA English DT Article ID POSITIVE AIRWAY PRESSURE; COLLEGE-OF-PHYSICIANS; APNEA SYNDROME; ORAL APPLIANCE; PREVALENCE; ATHEROMAS; ACCIDENTS; OBESITY; DEVICES; TRIAL AB The sleep apnoea/hypopnoea syndrome (SAHS) is characterized by repeated upper airway narrowing or collapse during sleep. The obstruction is caused by the soft palate and/or base of tongue collapsing against the pharyngeal walls because of decreased muscle tone. These episodes are accompanied by hypoxaemia, surges in blood pressure, brief arousal from sleep and pronounced snoring. individuals with occult disease are at heightened risk of motorway accidents because of excessive sleepiness, sustained hypertension, myocardial infarction, and stroke. The signs and symptoms of SAHS may be recognisable in the dental practice. Common findings in the medical history include daytime sleepiness, snoring, hypertension, and type 2 diabetes mellitus. Common clinical findings include merle gender, obesity, increased neck circumference, excessive fat deposition in the palate, tongue (macroglossia) and pharynx, a long soft palace, a small recessive mandible and maxilla, and calcified carotid artery atheromas on panoramic and lateral cephalometric radiographs. Dentists who recognise these signs and symptoms have an opportunity ca diagnose patients with occult SAHS. After confirmation of the diagnosis by a physician, dentists can participate in the management of the disorder by fabricating mandibular advancement appliances that enlarge the retroglossal space by anterior displacement of the tongue and performing corrective upper airway surgery that prevents recurrent airway obstruction. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Med Ctr, Hosp Dent Serv, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. Los Angeles Cty Dept Hlth, Panorama City, CA USA. VA Sepulveda Dent Serv, Sepulveda, CA USA. Univ Calif San Francisco, Sch Dent, Dept Oral & Maxillofacial Surg, San Francisco, CA 94143 USA. RP Friedlander, AH (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 56 TC 14 Z9 14 U1 0 U2 4 PU MACMILLAN PUBLISHERS LTD PI LONDON PA PORTERS SOUTH, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0007-0610 J9 BRIT DENT J JI Br. Dent. J. PD JUL 22 PY 2000 VL 189 IS 2 BP 76 EP 80 DI 10.1038/sj.bdj.4800687a PG 7 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 344JF UT WOS:000088754900019 PM 10975158 ER PT J AU Amory, JK Anawalt, BD Paulsen, CA Bremner, WJ AF Amory, JK Anawalt, BD Paulsen, CA Bremner, WJ TI Klinefelter's syndrome SO LANCET LA English DT Article ID MEN C1 Univ Washington, Populat Ctr Res Reprod, Seattle, WA 98195 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. RP Amory, JK (reprint author), Univ Washington, Populat Ctr Res Reprod, Seattle, WA 98195 USA. NR 8 TC 20 Z9 23 U1 0 U2 1 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JUL 22 PY 2000 VL 356 IS 9226 BP 333 EP 335 DI 10.1016/S0140-6736(00)02517-4 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 336MJ UT WOS:000088305900039 PM 11071204 ER PT J AU Ghosh-Choudhury, N Ghosh-Choudhury, G Celeste, A Ghosh, PM Moyer, M Abboud, SL Kreisberg, J AF Ghosh-Choudhury, N Ghosh-Choudhury, G Celeste, A Ghosh, PM Moyer, M Abboud, SL Kreisberg, J TI Bone morphogenetic protein-2 induces cyclin kinase inhibitor p21 and hypophosphorylation of retinoblastoma protein in estradiol-treated MCF-7 human breast cancer cells SO BIOCHIMICA ET BIOPHYSICA ACTA-MOLECULAR CELL RESEARCH LA English DT Article DE BMP-2; pRb; p21; breast cancer cell ID DEPENDENT KINASES; IN-VIVO; EXPRESSION; RECEPTOR; GENE; AMPLIFICATION; ACTIVATION; GROWTH; PROGRESSION; REGULATORS AB The biologic effects and mechanisms by which bone morphogenetic proteins (BMPs) function in breast cancer cells are not well defined. A member of this family of growth and differentiation factors, BMP-2, inhibited both basal and estradiol-induced growth of MCF-7 breast tumor cells in culture. Flow cytometric analysis showed that in the presence of BMP-2, 62% and 45% of estradiol-stimulated MCF-7 cells progressed to S-phase at 24 h and 48 h, respectively. Estradiol mediates growth of human breast cancer cells by stimulating cyclins and cyclin-dependent kinases (CDKs). BMP-2 significantly increased the Level of the cyclin kinase inhibitor, p21, which in turn associated with and inactivated cyclin D1. BMP-2 inhibited estradiol-induced cyclin D1-associated kinase activity. Also estradiol-induced CDK2 activity was inhibited by BMP-2. This inhibition of CDK activity resulted in hypophosphorylation of retinoblastoma protein thus keeping it in its active form. These data provide the first evidence by which BMP-2 inhibits estradiol-induced proliferation of human breast cancer cells. (C) 2000 Elsevier Science B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, GRECC, San Antonio, TX USA. Genet Inst, Boston, MA USA. RP Ghosh-Choudhury, N (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. FU NIDDK NIH HHS [DK-50190] NR 49 TC 66 Z9 69 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-4889 J9 BBA-MOL CELL RES JI Biochim. Biophys. Acta-Mol. Cell Res. PD JUL 21 PY 2000 VL 1497 IS 2 BP 186 EP 196 DI 10.1016/S0167-4889(00)00060-4 PG 11 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 338VW UT WOS:000088444800002 PM 10903423 ER PT J AU Kogai, T Schultz, JJ Johnson, LS Huang, M Brent, GA AF Kogai, T Schultz, JJ Johnson, LS Huang, M Brent, GA TI Retinoic acid induces sodium/iodide symporter gene expression and radioiodide uptake in the MCF-7 breast cancer cell line SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article ID THYROID NA+/I SYMPORTER; IODIDE TRANSPORT; TRANSCRIPTION FACTOR; GROWTH-INHIBITION; MAMMARY-GLAND; MESSENGER-RNA; FRTL-5 CELLS; THYROTROPIN; APOPTOSIS; PROTEIN AB The sodium/iodide symporter (NIS) stimulates iodide uptake in normal lactating breast, but is not known to be active in nonlactating breast or breast cancer. We studied NIS gene regulation and iodide uptake in MCF-7 cells, an estrogen receptor (ER)-positive human breast cancer cell line. All-trans retinoic acid (tRA) treatment stimulated iodide uptake in a time- and dose-dependent fashion up to approximate to 9.4-fold above baseline. Stimulation with selective retinoid compounds indicated that the induction of iodide uptake was mediated by retinoic acid receptor. Treatment with tRA markedly stimulated NIS mRNA and immunoreactive protein ( approximate to 68 kDa). tRA stimulated NIS gene transcription approximate to 4-fold, as shown by nuclear run-on assay. No induction of iodide uptake was observed with RA treatment of an ER-negative human breast cancer cell line, MDA-MB 231, or a normal human breast cell line, MCF-12A. The iodide efflux rate of tRA-treated MCF-7 cells was slow (t(1/2) = 24 min), compared with that in FRTL-5 thyroid cells (t(1/2) = 3.9 min), favoring iodide retention in MCF-7 cells. An in vitro clonogenic assay demonstrated selective cytotoxicity with I-131 after tRA stimulation of MCF-7 cells. tRA up-regulates NIS gene expression and iodide uptake in an ER-positive breast cancer cell line. Stimulation of radioiodide uptake after systemic retinoid treatment may be useful for diagnosis and treatment of some differentiated breast cancers. C1 W Los Angeles Vet Affairs Med Ctr, Mol Endocrinol Lab, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Physiol, Los Angeles, CA 90073 USA. RP Brent, GA (reprint author), W Los Angeles Vet Affairs Med Ctr, Mol Endocrinol Lab, 11301 Wilshire Blvd,Bldg 114,Room 230, Los Angeles, CA 90073 USA. NR 54 TC 101 Z9 104 U1 0 U2 1 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 USA SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD JUL 18 PY 2000 VL 97 IS 15 BP 8519 EP 8524 DI 10.1073/pnas.140217197 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 335YF UT WOS:000088273900061 PM 10890895 ER PT J AU Sato, N Ahuja, SK Quinones, M Kostecki, V Reddick, RL Melby, PC Kuziel, WA Ahuja, SS AF Sato, N Ahuja, SK Quinones, M Kostecki, V Reddick, RL Melby, PC Kuziel, WA Ahuja, SS TI CC chemokine receptor (CCR)2 is required for Langerhans cell migration and localization of T helper cell type 1 (Th1)-inducing dendritic cells: Absence of CCR2 shifts the Leishmania major-resistant phenotype to a susceptible state dominated by Th2 cytokines, B cell outgrowth, and sustained neutrophilic inflammation SO JOURNAL OF EXPERIMENTAL MEDICINE LA English DT Article DE infectious immunity; chemokine; cytokine; knockout; T helper cell ID SECONDARY LYMPHOID ORGANS; IN-VIVO; FLUORESCEIN ISOTHIOCYANATE; CUTANEOUS LEISHMANIASIS; MICE LACKING; IMMUNE-RESPONSE; TREATED MICE; BALB/C MICE; INFECTION; EXPRESSION AB There is growing evidence that chemokines and their receptors regulate the movement and interaction of antigen-presenting cells such as dendritic cells (DCs) and T cells. We tested the hy pothesis that the CC chemokine receptor (CCR)2 and CCR5 and the chemokine macrophage inflammatory protein (MIP)-1 alpha, a ligand for CCR5, influence DC migration and localization. We found that deficiency of CCR2 but not CCR5 or MIP-1 alpha led to distinct defects in DC biology. Langerhans cell (skin DC) density in CCR2-null mice was normal, and their ability to migrate into the dermis was intact; however, their migration to the draining lymph nodes was markedly impaired. CCR2-null mice had lower numbers of DCs in the spleen, and this was primarily due to a reduction in the CD8 alpha(+) T helper cell type 1 (Th1)-inducing subset of DCs. Additionally, there was a block in the Leishmania major infection-induced relocalization of splenic DCs from the marginal zone to the T cell areas. We propose that these DC defects, in conjunction with increased expression of B lymphocyte chemoattractant, a B cell-specific chemokine, may collectively contribute to the striking B cell outgrowth and Th2 cytokine-biased nonhealing phenotype that we observed in CCR2-deficient mice infected with L. major. This disease phenotype in mice with an L. major-resistant genetic background but lacking CCR2 is strikingly reminiscent of that observed typically in mice with an L. major-susceptible genetic background. Thus, CCR2 is an important determinant of not only DC migration and localization but also the development of protective cell-mediated immune responses to L. major. C1 S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. Univ Texas, Sect Mol Genet & Microbiol, Austin, TX 78712 USA. Univ Texas, Inst Mol & Cellular Biol, Austin, TX 78712 USA. RP Ahuja, SS (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Mail Code 7880,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 69 TC 200 Z9 204 U1 0 U2 3 PU ROCKEFELLER UNIV PRESS PI NEW YORK PA 1114 FIRST AVE, 4TH FL, NEW YORK, NY 10021 USA SN 0022-1007 J9 J EXP MED JI J. Exp. Med. PD JUL 17 PY 2000 VL 192 IS 2 BP 205 EP 218 DI 10.1084/jem.192.2.205 PG 14 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 335TP UT WOS:000088261100007 PM 10899907 ER PT J AU Altshuler, LL Bartzokis, G Grieder, T Curran, J Jimenez, T Leight, K Wilkins, J Gerner, R Mintz, J AF Altshuler, LL Bartzokis, G Grieder, T Curran, J Jimenez, T Leight, K Wilkins, J Gerner, R Mintz, J TI An MRI study of temporal lobe structures in men with bipolar disorder or schizophrenia SO BIOLOGICAL PSYCHIATRY LA English DT Review DE amygdala; bipolar; limbic; hippocampus; schizophrenia; temporal lobe ID FIRST-EPISODE SCHIZOPHRENIA; MONOZYGOTIC TWINS DISCORDANT; CAUDATE NUCLEI VOLUMES; CEREBRAL BLOOD-FLOW; MAGNETIC-RESONANCE; VENTRICULAR ENLARGEMENT; ALZHEIMERS-DISEASE; PREFRONTAL CORTEX; BRAIN MORPHOLOGY; BASAL GANGLIA AB Background: Hippocampal atrophy has been described in postmortem and magnetic resonance imaging studies of schizophrenia The specificity of this finding to schizophrenia remains to be determined, The neuropathology of bipolar disorder is understudied, and temporal lobe structures have only recently been evaluated. Methods: Twenty-four bipolar, 20 schizophrenic, and 18 normal comparison subjects were evaluated using magnetic resonance brain imaging, Image data were acquired using a three-dimensional spoiled GRASS sequence, and brain images were reformatted in three planes. Temporal lobe structures including the amygdala, hippocampus, parahippocampus, and total temporal lobe were measured to obtain volumes for each structure in the three subject groups, Severity of symptoms in both patient groups was assessed at the time the magnetic resonance images were obtained. Results: Hippocampal volumes were significantly smaller in rite schizophrenic group than in both bipolar and normal comparison subjects, Further, amygdala volumes were significantly larger in the bipolar group than in both schizophrenic and normal comparison subjects. Conclusions: The results suggest differences in affected limbic structures in patients with schizophrenia and bipolar disorder. These specific neuroanatomic abnormalities may shed light on the underlying pathophysiology and presentation of the two disorders. Biol Psychiatry 2000; 48:147-162 (C) 2000 Society of Biological Psychiatry. C1 Univ Calif Los Angeles, Mood Disorders Program, Dept Psychiat, Inst Neuropsychiat, Los Angeles, CA 90095 USA. W Los Angeles Vet Affairs Med Ctr, Psychiat Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Med Ctr, Dept Radiol Sci, Los Angeles, CA USA. Univ Arkansas Med Sci, Dept Psychiat, Little Rock, AR 72205 USA. Little Rock VA Med Ctr, Psychiat Serv, Little Rock, AR USA. RP Altshuler, LL (reprint author), Univ Calif Los Angeles, Mood Disorders Program, Dept Psychiat, Inst Neuropsychiat, 300 UCLA Med Plaza,Suite 1544, Los Angeles, CA 90095 USA. RI Bartzokis, George/K-2409-2013 NR 121 TC 258 Z9 263 U1 1 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD JUL 15 PY 2000 VL 48 IS 2 BP 147 EP 162 DI 10.1016/S0006-3223(00)00836-2 PG 16 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 335TC UT WOS:000088260000007 PM 10903411 ER PT J AU Choi, SJ Cruz, JC Craig, F Chung, H Devlin, RD Roodman, GD Alsina, M AF Choi, SJ Cruz, JC Craig, F Chung, H Devlin, RD Roodman, GD Alsina, M TI Macrophage inflammatory protein 1-alpha is a potential osteoclast stimulatory factor in multiple myeloma SO BLOOD LA English DT Article ID HUMAN-BONE-MARROW; MONOCLONAL-ANTIBODIES; CELL-FORMATION; B-CELLS; DISEASE; PLASMA; INTERLEUKIN-6; CULTURES; PROTEIN-1-ALPHA; HEMATOPOIESIS AB This study was designed to determine if macrophage inhibitory protein-1 alpha (MIP-1 alpha), a recently described osteoclast (OCL) stimulatory factor,(1) was present in marrow from patients with multiple myeloma (MM) and possibly involved in the bone destructive process. MIP-1 alpha, but not interleukin-1 beta (IL-1 beta), tumor necrosis factor-beta (TNF-beta), or interleukin-6 (IL-6), messenger RNA was elevated in freshly isolated bone marrow from 3 of 4 patients with MM compared to normal controls. Furthermore, enzyme-linked immunosorbent assays of freshly Isolated bone marrow plasma detected increased concentrations of hMIP-1 alpha (range, 75-7784 pg/mL) in 8 of 13 patients (62%) with active myeloma, in 3 of 18 patients (17%) with stable myeloma (range, 75-190.3), as well as in conditioned media from 4 of 5 lymphoblastoid cell lines (LCLs) derived from patients with MM, Mildly elevated levels of MIP-1 alpha were detected in 3 of 14 patients (21%) with other hematologic diagnoses (range, 80.2-118.3, median value of 95 pg/mL) but not in normal controls (8 of 7), MIP-1 alpha was not detected in the peripheral blood of any patients with MM, In addition, recombinant hMIP-1 alpha induced OCL formation in human bone marrow cultures. Importantly, addition of a neutralizing antibody to MIP-1 alpha to human bone marrow cultures treated with freshly isolated marrow plasma from patients with MM blocked the increased OCL formation induced by these marrow samples but had no effect on control levels of OCL formation. Thus, high levels of MIP-1 alpha are expressed in marrow samples from patients with MM, but not in marrow from patients with other hematologic disorders or controls, and support an important role for MIP-1 alpha as one of the major factors responsible for the increased OCL stimulatory activity in patients with active MM. (C) 2000 by The American Society of Hematology. C1 151 Audie L Murphy Vet Adm Hosp, Res Serv, San Antonio, TX 78284 USA. 151 Audie L Murphy Vet Adm Hosp, Gen Clin Res Ctr, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Hematol & Pathol, San Antonio, TX 78284 USA. St Francis Hosp & Med Ctr, Hartford, CT USA. Cheil Gen Hosp, Seoul, South Korea. RP Alsina, M (reprint author), 151 Audie L Murphy Vet Adm Hosp, Res Serv, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. FU NCI NIH HHS [CA40035, CA69136] NR 28 TC 269 Z9 275 U1 0 U2 3 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD JUL 15 PY 2000 VL 96 IS 2 BP 671 EP 675 PG 5 WC Hematology SC Hematology GA 335GB UT WOS:000088234800039 PM 10887133 ER PT J AU Li, SJ Yan, T Yang, JQ Oberley, TD Oberley, LW AF Li, SJ Yan, T Yang, JQ Oberley, TD Oberley, LW TI The role of cellular glutathione peroxidase redox regulation in the suppression of tumor cell growth by manganese superoxide dismutase SO CANCER RESEARCH LA English DT Article ID KAPPA-B-ALPHA; OXIDATIVE STRESS; ANTIOXIDANT ENZYMES; CU,ZN-SUPEROXIDE DISMUTASE; SIGNAL-TRANSDUCTION; MALIGNANT PHENOTYPE; PARAQUAT RESISTANCE; RAT HEPATOCYTES; CARCINOMA-CELLS; S-TRANSFERASES AB Manganese-containing superoxide dismutase (MnSOD) is an essential primary antioxidant enzyme that converts superoxide radical to hydrogen peroxide and molecular oxygen within the mitochondrial matrix. Cytosolic glutathione peroxidase (GPX) converts hydrogen peroxide into water, MnSOD is reduced in a variety of tumor types and has been proposed to be a new kind of tumor suppressor gene, but the mechanism(s) by which MnSOD suppresses malignancy is unclear. According to the enzymatic reactions catalyzed by MnSOD and cytosolic GPX, change in the cellular redox status, especially change attributable to accumulation of hydrogen peroxide or other hydroperoxides, is a possible reason to explain the suppression of tumor growth observed in MnSOD-overexpressing cells. To test this possible mechanism, we transfected human cytosolic GPX cDNA into human glioma cells overexpressing MnSOD. The results showed that GPX overexpression not only reversed the tumor cell growth inhibition caused by MnSOD overexpression but also altered the cellular contents of total glutathione, reduced glutathione, oxidized glutathione, and Intracellular reactive oxygen species, Overexpression of GPX also inhibited degradation of the inhibitory subunit alpha of nuclear factor-kappa B. These results suggest that hydrogen peroxide or other hydroperoxides appear to be key reactants in the tumor suppression by MnSOD overexpression, and growth inhibition correlates with the intracellular redox status. This work suggests that manipulations that inhibit peroxide removal should enhance the tumor suppressive effect of MnSOD overexpression. C1 Univ Iowa, Coll Med, Med Labs B180, Radiat Res Lab, Iowa City, IA 52242 USA. William S Middleton Mem Vet Hosp, Pathol Serv, Madison, WI 53705 USA. Univ Wisconsin, Dept Pathol & Lab Med, Madison, WI 53705 USA. RP Oberley, LW (reprint author), Univ Iowa, Coll Med, Med Labs B180, Radiat Res Lab, Iowa City, IA 52242 USA. FU NCI NIH HHS [CA 66081] NR 61 TC 199 Z9 204 U1 1 U2 8 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 0008-5472 J9 CANCER RES JI Cancer Res. PD JUL 15 PY 2000 VL 60 IS 14 BP 3927 EP 3939 PG 13 WC Oncology SC Oncology GA 337ML UT WOS:000088365300039 PM 10919671 ER PT J AU Lewinsohn, DM Briden, AL Reed, SG Grabstein, KH Alderson, MR AF Lewinsohn, DM Briden, AL Reed, SG Grabstein, KH Alderson, MR TI Mycobacterium tuberculosis-reactive CD8(+) T lymphocytes: The relative contribution of classical versus nonclassical HLA restriction SO JOURNAL OF IMMUNOLOGY LA English DT Article ID ANTIGEN-PRESENTING CELLS; BOVIS BCG; INFECTION; MICE; RESISTANCE; RESPONSES; ALPHA; LUNGS; MACROPHAGES; RECOGNITION AB Previous studies in mice and humans models have suggested an important role for CD8(+) T cells in host defense to Mycobacterium tuberculosis (Mtb), In humans, CD8(+) Mtb-reactive T cells have been described that are HLA-A2-, B52-, as well as CD1-restricted, Recently, we have described Mtb-specific CD8(+) T cells that are neither HLA-A-, B-, or C- nor group 1 CD1-restricted, At present, little is known about the relative contribution of each of these restriction specificities to the overall CD8(+) response to Mtb, An IFN-gamma enzyme-linked immunospot assay was used to determine the frequency of Mtb-reactive CD8(+) T cells directly from PBMC, The effector cell frequency among five healthy; purified protein derivative-positive subjects was 1/7,600 +/- 4,300 compared with 1/16,000 +/- 7,000 in six purified protein derivative-negative controls. To determine the frequencies of classically, CD1-, and nonclassically restricted cells, a limiting dilution analysis was performed. In one purified protein derivative-positive subject, 192 clones were generated using Mtb-infected dendritic cells (DC), clones were assessed for reactivity against control autologous DC, Mtb-infected autologous DC, and HLA-mismatched CD1(+) targets (DC), as well as HLA-mismatched CD1(-) targets (macrophages), Of the 96 Mtb-reactive CD8(+) T cell clones, four (4%) were classically restricted and 92 (96%) were nonclassically restricted. CD1-restricted cells were not detected. Of the classically restricted cells, two were HLA-B44 restricted and one was HLA-B14 restricted. These results suggest that while classically restricted CD8(+) lymphocytes can be detected, they comprise a relatively small component of the overall CD8(+) T cell response to Mtb, Further definition of the nonclassical response may aid development of an effective vaccine against tuberculosis. C1 Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Div Pulm & Crit Care Med, Portland, OR 97207 USA. Corixa Corp, Seattle, WA 98104 USA. RP Lewinsohn, DM (reprint author), Oregon Hlth Sci Univ, Portland Vet Affairs Med Ctr, Div Pulm & Crit Care Med, R&D 11,3710 US Vet Rd, Portland, OR 97207 USA. RI Lewinsohn, David/I-4936-2013 OI Lewinsohn, David/0000-0001-9906-9494 FU NIAID NIH HHS [1K08AI01644] NR 33 TC 73 Z9 75 U1 0 U2 2 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD JUL 15 PY 2000 VL 165 IS 2 BP 925 EP 930 PG 6 WC Immunology SC Immunology GA 332QU UT WOS:000088085600038 PM 10878367 ER PT J AU Chen, DX Lan, J Pei, W Chen, J AF Chen, DX Lan, J Pei, W Chen, J TI Detection of DNA base-excision repair activity for oxidative lesions in adult rat brain mitochondria SO JOURNAL OF NEUROSCIENCE RESEARCH LA English DT Article DE mitochondria; oxidative stress; DNA damage; base excision repair; brain ID BLUE PLUS LIGHT; POLYMERASE-GAMMA; PARKINSONS-DISEASE; XENOPUS-LAEVIS; RINR-38 CELLS; DAMAGE; SITES; AGE; GLYCOSYLASE; STRESS AB Endogenous oxidative damage to brain mitochondrial DNA and consequential disturbances of gene expression and mitochondrial dysfunction have long been implicated in aging and the pathogenesis of neurodegenerative diseases. It has yet to be determined, however, whether mitochondria in brain cells contain an active DNA repair system and, if so, how this system functions. Therefore, the capacity for the repair of defined types of oxidative DNA lesions has been investigated in adult rat brain mitochondria. Using in vitro DNA incorporation repair assay, we have detected base excision repair (BER) activity for the common oxidative DNA adduct 8-hydroxyl-2'-deoxyguanine (8-oxodG) in mitochondria protein extracts from cortical tissues and cultured primary cortical neurons and astrocytes. The levels of BER activity were both protein concentration-dependent and repair-incubation time-dependent. To resolve the BER pathway, the activity of essential BER enzymes was examined in mitochondria using oligonucleotide incision assay, DNA polymerase assay, and DNA ligase assay employing specific DNA substrates. Mitochondrial extracts were able to remove specifically 8-oxodG, uracil, and the apurinic/apyrimidinic abasic site from substrates. Moreover, a gamma-like DNA polymerase activity and a DNA ligase activity were detected in mitochondiral extracts, based on the formation of specific repair products. These results demonstrate that adult brain mitochondria possess an active BER system for repairing oxidative DNA lesions. This repair system appears to function by sequential actions of DNA repair enzymes that are homologous to, but not identical to, that in the nucleus. Thus, BER may represent an endogenous protective mechanism against oxidative damage to mitochondrial, as well as nuclear, genomes in brain cells. (C) 2000 Wiley-Liss, Inc. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Inst Brain & Aging, Pittsburgh, PA USA. Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Chen, J (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, S506 Biomed Sci Tower, Pittsburgh, PA 15213 USA. FU NINDS NIH HHS [NS36736, NS38560] NR 54 TC 36 Z9 37 U1 1 U2 4 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0360-4012 J9 J NEUROSCI RES JI J. Neurosci. Res. PD JUL 15 PY 2000 VL 61 IS 2 BP 225 EP 236 DI 10.1002/1097-4547(20000715)61:2<225::AID-JNR13>3.0.CO;2-0 PG 12 WC Neurosciences SC Neurosciences & Neurology GA 331AJ UT WOS:000087994500013 PM 10878595 ER PT J AU Johnson, J Rickman, DW Brecha, NC AF Johnson, J Rickman, DW Brecha, NC TI Somatostatin and somatostatin subtype 2A expression in the mammalian retina SO MICROSCOPY RESEARCH AND TECHNIQUE LA English DT Article DE bipolar cells; photoreceptors; amacrine cells; horizontal cells; neuropeptides ID ROD BIPOLAR CELLS; IMMUNOREACTIVE AMACRINE CELLS; C-LIKE IMMUNOREACTIVITY; ADULT CAT RETINA; RABBIT RETINA; RAT RETINA; CHROMATOGRAPHIC CHARACTERIZATION; HIPPOCAMPAL-NEURONS; RECEPTOR SUBTYPE; CHICKEN RETINA AB This review discusses the expression and cellular localization of the neuropeptide somatostatin (SRIF) and one of the SRIF subtype (sst) receptors, sst, in the mammalian retina. SRIF immunoreactivity is predominantly localized to a sparse population of amacrine and displaced amacrine cells in the ganglion cell layer in several mammalian retinas including the rat, rabbit, cat, and primate. These cells, characterized by multiple processes, form a sparse network in the inner plexiform layer (IPL) in all retinal regions. Very few processes are also in the outer plexiform layer. In contrast to the predominant distribution of SRIF processes to the IPL, there is a widespread distribution of sst(2A) immunoreactivity to both the inner and outer retina in all mammalian retinas studied to date. In rabbit retina, sst(2A) immunoreactivity is predominant in rod bipolar cells and in sparse wide-field amacrine cells. In the rat retina, sst(2A) immunoreactivity is localized to several neuronal cell types-cone photoreceptors, horizontal cells, rod and cone bipolar cells, and amacrine cells. Reverse-transcriptase-polymerase chain reaction analysis found that set, mRNA is expressed in the rat retina, while sst(2A) mRNA is not detected. Finally, in the primate retina sst(2) immunoreactivity is predominant in cone photoreceptors, with additional immunostained cell bodies and processes in the inner retina. These findings indicate that SRIF may modulate several neuronal cell types in the retina, and that it has a broad influence on both scotopic and photopic visual pathways. (C) 2000 Wiley-Liss. Inc. C1 Univ Calif Los Angeles, Med Ctr, Sch Med, Dept Neurobiol,CHS, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Jules Stein Eye Inst, Los Angeles, CA 90095 USA. Univ Calif San Francisco, Dept Ophthalmol, San Francisco, CA 94143 USA. Univ Iowa, Dept Ophthalmol & Visual Sci, Iowa City, IA USA. CURE, Digest Dis Res Ctr, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Brecha, NC (reprint author), Univ Calif Los Angeles, Med Ctr, Sch Med, Dept Neurobiol,CHS, 10833 Le Conte Ave,Box 951763, Los Angeles, CA 90095 USA. FU NEI NIH HHS [EY11389, EY04067, EY07026] NR 64 TC 27 Z9 27 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 1059-910X J9 MICROSC RES TECHNIQ JI Microsc. Res. Tech. PD JUL 15 PY 2000 VL 50 IS 2 BP 103 EP 111 DI 10.1002/1097-0029(20000715)50:2<103::AID-JEMT2>3.0.CO;2-X PG 9 WC Anatomy & Morphology; Biology; Microscopy SC Anatomy & Morphology; Life Sciences & Biomedicine - Other Topics; Microscopy GA 336PB UT WOS:000088310800002 PM 10891874 ER PT J AU Choudhury, GG Ricono, JM AF Choudhury, GG Ricono, JM TI Increased effect of interferon gamma on PDGF-induced c-fos gene transcription in glomerular mesangial cells: Differential effect of the transcriptional coactivator CBP on STAT1 alpha activation SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE PDGF; interferon gamma; c-fos; sis-inducible element ID SERUM RESPONSE ELEMENT; GROWTH-FACTOR; MEDIATED ACTIVATION; SIGNAL-TRANSDUCTION; DNA-SYNTHESIS; KINASE; PROMOTER; TYROSINE; RECEPTOR; PATHWAYS AB We have previously shown that interferon gamma (IFN gamma) synergistically increases PDGF-induced DNA synthesis in mesangial cells. To examine the mechanism, we studied its effect on PDGF-induced c-fos gene transcription using a reporter mesangial cell in which firefly luciferase gene is driven by c-fos promoter. IFN gamma significantly enhanced PDGF-induced c-fos transcription, We have shown previously that PDGF-induced c-fos transcription in mesangial cells is mediated by the ternary complex factor Elk-1. Using a GAL-4 DNA binding-domain-Elk-1 transactivation domain fusion protein-based reporter assay we showed that the increased effect of IFN gamma was not mediated by Elk-1 transactivation. Gel mobility shift assay of lysates of mesangial cells treated with a combination of IFN gamma and PDGF using sis-inducible DNA element (SIE) showed increased STAT1 alpha-SIE complex formation as compared to the PDGF alone. To investigate the transcriptional consequences of this observation, stable reporter mesangial cells in which luciferase gene is driven by four copies of SIE was used, IFN gamma and PDGF in combination significantly increased SIE-dependent transcription as compared to PDGF or IFN gamma alone. Using an antibody in the gel mobility shift assay we showed that the PDGF-induced STE-STAT1 alpha complex recruited the transcriptional coactivator CBP. However, the STA1 alpha-SIE complex formed in the presence of IFN gamma and PDGF did not contain CBP. Taken together, our data provide the first evidence that the synergistic effect of IFN gamma on PDGF-induced DNA synthesis may be the result of increased c-fos gene transcription via SIE. This effect occurs in the presence of increased activation of STAT1 alpha without recruitment of the transcriptional coactivator CBP. (C) 2000 Academic Press. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. S Texas Vet hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Choudhury, GG (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Floyd Curl Dr, San Antonio, TX 78284 USA. NR 42 TC 5 Z9 6 U1 0 U2 0 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD JUL 14 PY 2000 VL 273 IS 3 BP 1069 EP 1077 DI 10.1006/bbrc.2000.3081 PG 9 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 337LX UT WOS:000088363700048 ER PT J AU Ganzini, L Lee, MA Schmidt, TA AF Ganzini, L Lee, MA Schmidt, TA TI Physician-assisted suicide and euthanasia. Reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. Providence Hlth Syst, Portland, OR 97218 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Ganzini, L (reprint author), Portland Vet Affairs Med Ctr, Portland, OR 97201 USA. NR 5 TC 3 Z9 3 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JUL 13 PY 2000 VL 343 IS 2 BP 151 EP 152 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 333EP UT WOS:000088116500028 ER PT J AU Pettinati, HM Volpicelli, JR Kranzler, HR Luck, G Rukstalis, MR Cnaan, A AF Pettinati, HM Volpicelli, JR Kranzler, HR Luck, G Rukstalis, MR Cnaan, A TI Sertraline treatment for alcohol dependence: Interactive effects of medication and alcoholic subtype SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article; Proceedings Paper CT 37th Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 11-18, 1998 CL LAS CROABAS, PUERTO RICO SP Amer Coll Neuropsychopharmacol DE alcoholism; alcoholic subtypes; SSRI pharmacotherapy; sertraline ID PLACEBO-CONTROLLED TRIAL; ETHANOL INTAKE; B ALCOHOLICS; DOUBLE-BLIND; FLUOXETINE; TRYPTOPHAN; ONSET; CONSUMPTION; BEHAVIOR; DRINKERS AB Background: Characteristic behaviors of some alcohol-dependent individuals, e.g., binge drinking, comorbid psychopathology, and some types of alcohol-related problems, have been linked to abnormalities in serotonergic neurotransmission. However, studies that have evaluated serotonergic pharmacotherapy for reducing drinking have yielded conflicting results. One explanation for these findings is a general failure to distinguish alcohol subgroups that may be differentiated on the basis of serotonergic abnormalities. However, in 1996, Kranzler and colleagues reported that Type B alcoholics, who are characterized by high levels of premorbid vulnerability, alcohol dependence severity, and comorbid psychopathology, showed less favorable drinking outcomes in response to treatment with fluoxetine, a serotonin reuptake inhibitor, than with placebo. This medication effect was not seen in Type A alcoholics, i.e., those with lower risk/severity of alcoholism and psychopathology. The aim of the present study was to explore the validity of differential responding by alcohol-dependent subtypes using the serotonin reuptake inhibitor, sertraline. Methods: A k-means clustering procedure was applied to a sample of alcohol-dependent subjects enrolled in a 14-week, placebo-controlled trial of 200 mg/day of sertraline, classifying them into lower-risk severity (Type A: n = 55) and higher-risk/severity (Type B: n = 45) subgroups. Results: A significant interaction between alcoholic subtype and medication condition was found, confirming the findings of Kranzler and colleagues that alcoholic subtypes responded differentially to serotonergic medication. Somewhat at variance with their results, however, the present study showed that the lower risk/severity (Type A) subjects had more favorable outcomes when treated with sertraline compared to placebo. Conclusions: Alcoholic subtypes differentially responded to sertraline when used as a treatment to reduce alcohol drinking, with one subtype having more favorable outcomes. Subtyping alcoholics may help to resolve conflicting findings in the literature on serotonergic treatment of alcohol dependence. C1 Univ Penn, Sch Med, Dept Psychiat, Addict Treatment Res Ctr, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Psychiat, Ctr Study Addict, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Univ Connecticut, Sch Med, Alcohol Res Ctr, Dept Psychiat, Farmington, CT USA. RP Pettinati, HM (reprint author), Univ Penn, Sch Med, Dept Psychiat, Addict Treatment Res Ctr, Philadelphia, PA 19104 USA. FU NIAAA NIH HHS [K02-AA00239, R01-AA09544] NR 53 TC 144 Z9 148 U1 2 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUL PY 2000 VL 24 IS 7 BP 1041 EP 1049 DI 10.1097/00000374-200007000-00015 PG 9 WC Substance Abuse SC Substance Abuse GA 334XV UT WOS:000088212400015 PM 10924008 ER PT J AU Ortiz, F Fitten, LJ AF Ortiz, F Fitten, LJ TI Barriers to healthcare access for cognitively impaired older Hispanics SO ALZHEIMER DISEASE & ASSOCIATED DISORDERS LA English DT Article DE access barrier; aged; cognitively impaired; dementia; elderly; healthcare access; Hispanics ID ILLNESS RATING-SCALE; MEXICAN-AMERICANS; ELDERLY HISPANICS; MENTAL-HEALTH; PSYCHOLOGICAL DISTRESS; ALZHEIMERS-DISEASE; LOS-ANGELES; SERVICES; COMMUNITY; PREVALENCE AB This study describes the development of the Barriers to Healthcare Access Survey (BHAS) used to evaluate seven barrier factors believed to influence healthcare access Fur elderly Hispanics with memory or cognitive problems. This study further reports the results: of the BHAS applied to a community sample of cognitively impaired older Hispanics and their caregivers. The study includes (1) The BHAS's development and procedures to establish instrument validity and reliability; (2) Interviews with the BHAS on 65 cognitively impaired Hispanics who were undergoing full diagnostic assessment for dementia and their caregivers. The most frequently perceived healthcare barriers reported in our study were related to (1) personal beliefs (38%), (2) language proficiency (33%), and (3) economic status (13%). The BHAS possesses the requisite psychometric properties to be an effective instrument for an initial survey of perceived barriers to access health care for low-education, cognitively impaired, elderly Hispanic patients. The findings suggest that perceptions regarding illness, health consequences of aging, and beliefs about the utility of medicine do, in fact, influence healthcare use by older Hispanic patients with dementia. Language proficiency and economic status remain common barriers among elderly Hispanic subgroups, but when these barriers are experienced by the cognitively impaired, serious healthcare implications: ensue, especially delay in early diagnosis and treatment. C1 Greater Los Angeles Vet Affairs Healthcare Syst, N Hills, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Alzheimers Dis Res Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA USA. RP Ortiz, F (reprint author), Greater Los Angeles Vet Affairs Healthcare Syst, Sepulveda Campus,16111 Plummer St 116A-9, N Hills, CA 91343 USA. FU NIA NIH HHS [P50AG16570] NR 57 TC 34 Z9 34 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0893-0341 J9 ALZ DIS ASSOC DIS JI Alzheimer Dis. Assoc. Dis. PD JUL-SEP PY 2000 VL 14 IS 3 BP 141 EP 150 DI 10.1097/00002093-200007000-00005 PG 10 WC Clinical Neurology; Pathology SC Neurosciences & Neurology; Pathology GA 350PP UT WOS:000089110600005 PM 10994655 ER PT J AU Vakil, N Rhew, D Soll, A Ofman, JJ AF Vakil, N Rhew, D Soll, A Ofman, JJ TI The cost-effectiveness of diagnostic testing strategies for Helicobacter pylori SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID UREA BREATH TEST; PEPTIC-ULCER DISEASE; DYSPEPTIC PATIENTS; NONINVASIVE TESTS; UNITED-STATES; ENZYME-IMMUNOASSAY; GOLD STANDARD; ANTIBODY-TEST; PRIMARY-CARE; FLEXSURE HP AB OBJECTIVE: Several noninvasive methods are now available for diagnosing Helicobacter pylori infection. Because the prevalence of H. pylori infection is variable in patients requiring testing, the optimal testing strategies may vary under different conditions. The aim of this study was to evaluate the cost-effectiveness of competing diagnostic strategies for H. pylori in patients with varying H. pylori prevalence. METHODS: A decision analysis was performed comparing the costs per number of correct diagnoses achieved by alternative sequential testing strategies. Estimates of H. pylori prevalence and test characteristics were derived from a systematic review of the MEDLINE bibliographic database. Cost estimates were derived from the 2000 Medicare Fee Schedule. RESULTS: The enzyme-linked immunosorbent assay (ELISA) test had the lowest cost per correct diagnosis at low (30%), intermediate (60%), and high (90%) prevalence ($90-$95/correct diagnosis), but its diagnostic accuracy was low (80-84%). At low and intermediate prevalence the stool test was more accurate (93%), with an average cost of $126-$127 per correct diagnosis. Additional confirmatory testing of positive or negative tests increased the diagnostic accuracy of the stool test, but had high incremental costs. ELISA testing was preferable when prevalence rates were very high (90%), and using a confirmatory urea breath test for negative ELISA tests increased the diagnostic accuracy to 96%, with modest incremental costs. If the cost of the breath test was <$50 or if the cost of the stool test is >$82, breath testing became preferable to stool testing. If the cost of the stool test fell to <$20, it became preferable to ELISA. Similarly, if the cost of the ELISA serology was >$39 then stool testing became preferable at all prevalence rates. Fingerstick whole blood tests were not cost-effective. CONCLUSIONS: The choice of an initial test for H. pylori detection depends on the prevalence of H. pylori infection and the value placed on increased diagnostic accuracy. Al though ELISA results in the lowest cost-effectiveness ratios, in patients at low-intermediate pretest probability of infection, the stool test provides increased accuracy, with modest incremental costs. (C) 2000 by Am. Cell. of Gastroenterology. C1 Univ Wisconsin, Sch Med, Sinai Samaritan Med Ctr, Div Gastroenterol,Dept Med, Milwaukee, WI 53233 USA. Zynx Hlth Inc, Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Dept Med, Los Angeles, CA 90073 USA. Cedars Sinai Med Ctr, Div Gastroenterol, Dept Med, Los Angeles, CA 90048 USA. Cedars Sinai Med Ctr, Div Gastroenterol, Dept Hlth Serv Res, Los Angeles, CA 90048 USA. RP Vakil, N (reprint author), Univ Wisconsin, Sch Med, Sinai Samaritan Med Ctr, Div Gastroenterol,Dept Med, 945 N 12th St,Room 4040, Milwaukee, WI 53233 USA. NR 89 TC 53 Z9 54 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD JUL PY 2000 VL 95 IS 7 BP 1691 EP 1698 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 335DX UT WOS:000088229000013 PM 10925969 ER PT J AU Korosi, A Kahn, T Kalb, T Uribarri, J AF Korosi, A Kahn, T Kalb, T Uribarri, J TI Marked hyperlactatemia associated with severe alkalemia in a patient with thrombotic thrombocytopenic purpura SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE alkalosis; lactate; thrombotic thrombocytopenic purpura (TTP); hypoxia ID METABOLIC ALKALOSIS; PH AB This report describes a case of severe alkalemia associated with a blood lactate level greater than 13 mEq/L in a patient without evidence of hypotension or hypoxemia. The patient, who had the clinical manifestations of thrombotic thrombocytopenic purpura (TTP), developed the alkalemia from an acute respiratory alkalosis superimposed on an existing metabolic alkalosis. Profound alkalemia may impair oxygen delivery because of stronger hemoglobin-oxygen affinity, vasoconstriction, and alterations in the redox potential of cytochrome c. We suggest that the synergistic effects of a sudden, extreme alkalemia and the localized tissue hypoxia that resulted from extensive microvascular thrombi secondary to TTP caused the patient's hyperlactatemia. (C) 2000 by the National Kidney Foundation, Inc. C1 Mt Sinai Med Ctr, Div Nephrol, New York, NY 10029 USA. Mt Sinai Med Ctr, Dvi Pulmonol, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, Renal Sect, Bronx, NY USA. RP Korosi, A (reprint author), Mt Sinai Med Ctr, Div Nephrol, Box 1243,1 Gustave L Levy Pl, New York, NY 10029 USA. NR 13 TC 3 Z9 3 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD JUL PY 2000 VL 36 IS 1 BP art. no. EP e6 DI 10.1053/ajkd.2000.8303 PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 331FM UT WOS:000088007700041 PM 10873905 ER PT J AU Giri, D Ittmann, M AF Giri, D Ittmann, M TI Interleukin-1 alpha is a paracrine inducer of FGF7, a key epithelial growth factor in benign prostatic hyperplasia SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Article ID FACTOR GENE-EXPRESSION; FIBROBLASTS; CELLS AB Benign prostatic hyperplasia (BPN) is an extremely common disease of older men In which there is benign overgrowth of the prostatic transition zone, leading to obstruction of urine outflow, FGF7, a potent growth factor for prostatic epithelial cells, is increased by threefold in BPH and is correlated with increased epithelial proliferation in this condition. Immunohistochemistry of normal and hyperplastic prostate revealed that FGF7-expressing fibroblastic cells were present in higher numbers near the epithelial acini, implying that epithelial cells may express a factor that induces FGF7 expression by stromal cells. Conditioned medium (CM) from primary cultures of prostatic epithelial cells was capable of inducing a two- to sixfold increase in time expression of FGF7 by primary stromal cultures. Blocking experiments with neutralizing anti-interleukin-1 alpha(I1-1 alpha) antibodies and IL-1Ra, an I1-1 alpha receptor antagonist, show that this inducing activity was due to the presence of I1-1 alpha in the epithelial CM. Analysis of normal prostatic peripheral zone and BPH tissue by enzyme-linked immunoabsorption assay reveal that I1-1 alpha is present at increased levels in hyperplastic prostate and that levels of I1-1 alpha correlate strongly with tissue FGF7 concentration In BPH, Therefore I1-1 alpha is produced by prostatic epithelial cells and can induce FGF7, a potent epithelial growth factor, which can in turn lead to further epithelial growth and increased I1-1 alpha secretion, thus establishing a double paracrine loop that is functionally equivalent to an autocrine growth loop. This double paracrine loop may play a key role in the abnormal proliferation of the transition zone, which is critical to the pathogenesis of BPH. C1 Houston Dept Vet Affairs Med Ctr, Res Serv 151, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. RP Ittmann, M (reprint author), Houston Dept Vet Affairs Med Ctr, Res Serv 151, 2002 Holcombe Blvd, Houston, TX 77030 USA. FU NIDDK NIH HHS [R01 DK54170, R01 DK054170] NR 21 TC 47 Z9 48 U1 0 U2 1 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BALTIMORE PA 428 EAST PRESTON ST, BALTIMORE, MD 21202-3993 USA SN 0002-9440 J9 AM J PATHOL JI Am. J. Pathol. PD JUL PY 2000 VL 157 IS 1 BP 249 EP 255 DI 10.1016/S0002-9440(10)64535-X PG 7 WC Pathology SC Pathology GA 332TL UT WOS:000088089500028 PM 10880394 ER PT J AU Keire, DA Mannon, P Kobayashi, M Walsh, JH Solomon, TE Reeve, JR AF Keire, DA Mannon, P Kobayashi, M Walsh, JH Solomon, TE Reeve, JR TI Primary structures of PYY, [Pro(34)]PYY, and PYY-(3-36) confer different conformations and receptor selectivity SO AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY LA English DT Article DE peptide YY; Y-1 receptor; Y-2 receptor; circular dichroism; nuclear magnetic resonance; three-dimensional structure ID AMPHIPHILIC SECONDARY STRUCTURES; HUMAN NEUROPEPTIDE-Y; PEPTIDE-YY; PANCREATIC-POLYPEPTIDE; AQUEOUS-SOLUTION; Y-2 RECEPTORS; ANALOGS; BINDING; DYNAMICS; CELLS AB We synthesized PYY-(1-36) (nonselective between Y-1 and Y-2 receptor subtype agonists), [Pro(34)]-PYY (selective for Y-1), and PYY-(3-36) (selective for Y-2) to determine whether solution conformation plays a role in receptor subtype selectivity. The three peptides exhibited the expected specificities in displacing labeled PYY-(1-36) from cells transfected with Y-1 receptors (dissociation constants = 0.42, 0.21, and 1,050 nM, respectively) and from cells transfected with Y2 receptors (dissociation constants = 0.03, 710, and 0.11 nM, respectively) for PYY-(1-36), [Pro(34)]PYY, and PYY-(3-36). Sedimentation equilibrium analyses revealed that the three PYY analogs were 80-90% monomer at the concentrations used for the subsequent circular dichroism (CD) and H-1-nuclear magnetic resonance (NMR) studies. CD analysis measured helicities for PYY-(1-36), [Pro(34)]PYY, and PYY-(3-36) of 42%, 31%, and 24%, suggesting distinct differences in secondary structure. The backbone H-1-NMR resonances of the three peptides further substantiated marked conformational differences. These patterns support the hypothesis that Y-1 and Y-2 receptor subtype binding affinities depend on the secondary and tertiary solution state structures of PYY and its analogs. C1 Greater Los Angeles Vet Affairs Healthcare Syst, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. City Hope Natl Med Ctr, Beckman Res Inst, Duarte, CA 91010 USA. Vet Affairs Med Ctr, Durham, NC 27705 USA. Duke Univ, Med Ctr, Durham, NC 27705 USA. Univ Calif Los Angeles, Sch Med, Div Digest Dis, Los Angeles, CA 90095 USA. RP Reeve, JR (reprint author), Greater Los Angeles Vet Affairs Healthcare Syst, CURE Digest Dis Res Ctr, Rm 115,Bld 115, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK-41301, DK-33850] NR 30 TC 81 Z9 82 U1 0 U2 6 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0193-1857 J9 AM J PHYSIOL-GASTR L JI Am. J. Physiol.-Gastroint. Liver Physiol. PD JUL PY 2000 VL 279 IS 1 BP G126 EP G131 PG 6 WC Gastroenterology & Hepatology; Physiology SC Gastroenterology & Hepatology; Physiology GA 333RN UT WOS:000088144700015 PM 10898754 ER PT J AU Washington, DL Stevens, CD Shekelle, PG Baker, DW Fink, A Brook, RH AF Washington, DL Stevens, CD Shekelle, PG Baker, DW Fink, A Brook, RH TI Safely directing patients to appropriate levels of care: Guideline-driven triage in the emergency service SO ANNALS OF EMERGENCY MEDICINE LA English DT Article; Proceedings Paper CT Va Health Services Research and Development National Meeting CY FEB 24-26, 1999 CL WASHINGTON, D.C. SP VA Hlth Serv Res & Dev Natl ID PUBLIC HOSPITAL EMERGENCY; REFUSING CARE; CONSEQUENCES; DEPARTMENTS; PHYSICIAN; LEAVE AB Study objective: We sought to develop and Validate standardized clinical criteria to identify patients presenting to the emergency department whose care may be safely deferred to a later date in a nonemergency setting. Methods: Using a modified Delphi process, a 17-member multidisciplinary physician panel developed explicit, standardized, deferred-care criteria. In a prospective cohort design, emergency nurses at a tertiary care Veterans Administration (VA) Medical Center, using the criteria, screened 1,187 consecutive ambulatory adult patients presenting with abdominal pain, musculoskeletal symptoms, or respiratory infection symptoms. Patients meeting deferred-care criteria were offered the option of an appointment within 1 week in the ambulatory care clinic at the study site; ail other patients were offered same-day care. As outcome measures, we assessed nonelective hospitalizations for related conditions occurring within 7 days of evaluation at our facility or any other VA facility within a 300-mile radius, and we assessed 30-day all-cause mortality. Results: Two hundred twenty-six (19%) patients met screening criteria for deferred care. Patients meeting deferred-care criteria experienced zero (95% confidence interval, 0% to 1.2%) related nonelective VA hospitalizations within 7 days of evaluation, and none died within 30 days. By contrast, 68 (7%) of 961 (95% confidence interval, 5.5% to 8.9%) patients who did not meet deferred-care criteria were hospitalized nonelectively for related conditions, and 5 (0.5%) died. Conclusion: By using hospitalization and 30-day mortality as safety gauges, standardized clinical criteria can identify, at presentation, VA ED users who may be safely cared for at a later dale in a nonemergency setting. These guidelines apply to a significant proportion of VA ED users with common ambulatory conditions. These criteria deserve testing in other ED settings. C1 VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Ctr Hlth Sci, Dept Med, Los Angeles, CA 90024 USA. Harbor UCLA Med Ctr, Dept Emergency Med, Torrance, CA 90509 USA. Case Western Reserve Univ, Sch Med, Dept Med, Cleveland, OH 44106 USA. Case Western Reserve Univ, Sch Med, Dept Epidemiol Biostat, Cleveland, OH 44106 USA. Metrohlth Med Ctr, Cleveland, OH 44106 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Sci, Los Angeles, CA 90024 USA. RAND, Hlth Sci Program, Santa Monica, CA USA. RP Washington, DL (reprint author), VA Greater Los Angeles Healthcare Syst, Dept Med, 11301 Wilshire Blvd,111G, Los Angeles, CA 90073 USA. NR 27 TC 18 Z9 18 U1 1 U2 1 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD JUL PY 2000 VL 36 IS 1 BP 15 EP 22 DI 10.1067/mem.2000.107003 PG 8 WC Emergency Medicine SC Emergency Medicine GA 330YG UT WOS:000087988700003 PM 10874230 ER PT J AU Sarraf, D Payne, AM Kitchen, ND Sehmi, KS Downes, SM Bird, AC AF Sarraf, D Payne, AM Kitchen, ND Sehmi, KS Downes, SM Bird, AC TI Familial cavernous hemangioma - An expanding ocular spectrum SO ARCHIVES OF OPHTHALMOLOGY LA English DT Article ID CENTRAL NERVOUS-SYSTEM; RETINA; MALFORMATIONS; MANIFESTATIONS; INVOLVEMENT AB Objective: To describe the clinical and genetic findings in a family with multiple cases of cavernous hemangiomas. Design: Investigational clinical and genetic study in which 3 generations of a family consisting of 12 members were screened with magnetic resonance brain imaging, dilated ophthalmoscopic examination, and cutaneous survey coupled with linkage analysis to determined affected individuals and to better define manifestations of this neuro-oculo-cutaneous syndrome. Results: The proband had multiple cerebral cavernous hemangiomas and a choroidal hemangioma. Her son was found to harbor a retinal cavernous hemangioma. The proband's sister manifested a cerebral cavernous hemangioma cutaneous hemangiomas, and a presumed choroidal hemangioma; her daughter demonstrated radiological findings suggestive of a cerebral cavernous hemangioma. The father of the proband demonstrated multiple, cutaneous hemangiomas. The remaining family members were free of lesions. The 7q locus could not be excluded as harboring the causative gene. Conclusions: This family may have a dominantly inherited neuro-oculo-cutaneous condition of cavernous hemangiomas with variable expressivity. The presence of choroidal hemangiomas in this phacomatosis has not been described previously to our knowledge. Clinical Relevance: The presence of either retinal cavernous or choroidal hemangioma should alert the physician to search for features suggestive of systemic and familial involvement; either lesion may constitute the ocular component of the neuro-oculo-cutaneous phacomatosis, sometimes referred to as cavernoma multiplex. C1 Univ Calif Los Angeles, Jules Stein Eye Inst, Sch Med, Los Angeles, CA 90095 USA. Univ Halle Wittenberg, Med Ctr, D-4010 Halle, Germany. Greater Los Angeles Vet Adm Healthcare Ctr, Dept Ophthalmol, Los Angeles, CA USA. Inst Ophthalmol, London, England. Moorfields Eye Hosp, London, England. Inst Neurol, London, England. RP Sarraf, D (reprint author), Univ Calif Los Angeles, Jules Stein Eye Inst, Sch Med, 100 Stein Plaza, Los Angeles, CA 90095 USA. NR 25 TC 21 Z9 21 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9950 J9 ARCH OPHTHALMOL-CHIC JI Arch. Ophthalmol. PD JUL PY 2000 VL 118 IS 7 BP 969 EP 973 PG 5 WC Ophthalmology SC Ophthalmology GA 334CZ UT WOS:000088169100015 PM 10900112 ER PT J AU Bostwick, DG Alexander, EE Singh, R Shan, A Qian, JQ Santella, RM Oberley, LW Yan, T Zhong, WX Jiang, XH Oberley, TD AF Bostwick, DG Alexander, EE Singh, R Shan, A Qian, JQ Santella, RM Oberley, LW Yan, T Zhong, WX Jiang, XH Oberley, TD TI Antioxidant enzyme expression and reactive oxygen species damage in prostatic intraepithelial neoplasia and cancer SO CANCER LA English DT Article DE prostatic intraepithelial neoplasia; superoxide dismutase; catalase; reactive oxygen species; antioxidant enzymes; prostatic neoplasms; prostate carcinoma ID GLUTATHIONE-S-TRANSFERASE; SUPEROXIDE-DISMUTASE ACTIVITY; IN-SITU HYBRIDIZATION; CARCINOMA-CELLS; CHROMOSOMAL-ANOMALIES; INDEPENDENT ORIGIN; OXIDATIVE STRESS; CONTROLLED TRIAL; ADENOCARCINOMA; DNA AB BACKGROUND. Oxidative stress results in damage to cellular structures and has been linked to many diseases, including cancer. The authors sought to determine whether the expression of three major antioxidant enzymes, copper-zinc superoxide dismutase (SOD1), manganese superoxide dismutase (SOD2), and catalase, was altered in human prostate carcinoma and its likely precursor, high grade prostatic intraepithelial neoplasia (PIN). The level of reactive oxygen species damage was evaluated by measuring the expression of the DNA adduct 8-hydroxydeoxyguanosine. METHODS. The authors evaluated the tissue expression of the antioxidant enzymes in prostate carcinoma by immunohistochemistry, immunogold electron microscopy, and enzymatic assay. The polymerase chain reaction was used to amplify and screen tissue specimens for the genes of SOD1, SOD2, and extracellular SOD (SOD3). Matched paraffin embedded tissue sections were evaluated by RNA in situ hybridization for expression of SOD1 and immunohistochemically for the DNA adduct 8-hydroxydeoxyguanosine. RESULTS. All prostatic tissues, including cancer, displayed immunoreactivity for the three antioxidant enzymes in epithelial cells, with no staining of the stroma, inflammatory cells, or endothelial cells. The number of immunoreactive cells was greater in benign epithelium than in PIN and cancer for each enzyme. The mean percentage rand intensity of immunoreactive cells was greatest for SOD2, intermediate for SODI, and lower for catalase. Staining in cancer was heterogeneous. Immunogold ultrasound studies revealed strong mitochondrial labeling for SOD2, which was greater in benign epithelium than in cancer; SOD1 labeling was invariably weaker, with nuclear labeling in benign epithelium and cytoplasmic labeling in cancer cells. There was no difference in enzyme activity for the three antioxidant enzymes between benign epithelium and cancer. No mutations were found in the 5 exons of SOD1, 5 exons of SOD2, and 3 exons of SOD3, except for 3 of 20 cases with polymorphisms for exon 3 of SOD1. Intense nuclear immunoreactivity for 8-hydroxydeoxyguanosine was present in fewer than 3% of epithelial cells, with no apparent differences among benign epithelium, PIN, and cancer. CONCLUSIONS. SOD1, SOD2, and catalase had lower expression in PIN and prostate carcinoma than in benign epithelium. The number of immunoreactive cells in PIN was similar to cancer, indicating that these are closely related. Enzyme activities were variable, with no difference between benign epithelial cells and cancer, although this lack of change in enzyme activity could have been due to the presence of contaminating benign cells within the cancer specimens. The results of reactive oxygen species damage were found only in the epithelium and not in the stroma. Expression of the DNA adduct 8-hydroxydeoxyguanosine was present in fewer than 3% of cells, with no apparent differences among benign epithelium, PIN, and cancer. These findings suggest that oxidative stress is an early event in carcinogenesis. (C) 2000 American Cancer Society. C1 Bostwick Labs, Richmond, VA 23294 USA. Univ Virginia, Dept Pathol, Charlottesville, VA 22903 USA. Mayo Clin & Mayo Fdn, Dept Urol, Rochester, MN 55905 USA. Columbia Presbyterian Med Ctr, New York, NY 10032 USA. Univ Iowa, Coll Med, Radiat Res Lab, Iowa City, IA USA. William S Middleton Mem Vet Hosp, Pathol & Lab Med Serv, Madison, WI 53705 USA. RP Bostwick, DG (reprint author), Bostwick Labs, 9351 W Broad St, Richmond, VA 23294 USA. NR 53 TC 175 Z9 188 U1 0 U2 6 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0008-543X J9 CANCER JI Cancer PD JUL 1 PY 2000 VL 89 IS 1 BP 123 EP 134 DI 10.1002/1097-0142(20000701)89:1<123::AID-CNCR17>3.0.CO;2-9 PG 12 WC Oncology SC Oncology GA 331KJ UT WOS:000088017800018 PM 10897009 ER PT J AU Babbitt, JT Kharazi, AI Taylor, JMG Bonds, CB Mirell, SG Frumkin, E Zhuang, DL Hahn, TJ AF Babbitt, JT Kharazi, AI Taylor, JMG Bonds, CB Mirell, SG Frumkin, E Zhuang, DL Hahn, TJ TI Hematopoietic neoplasia in C57BL/6 mice exposed to split-dose ionizing radiation and circularly polarized 60 Hz magnetic fields SO CARCINOGENESIS LA English DT Article ID ACUTE LYMPHOBLASTIC-LEUKEMIA; ELECTRIC UTILITY WORKERS; ELECTROMAGNETIC-FIELDS; CHILDHOOD LEUKEMIA; BRAIN-TUMORS; OCCUPATIONAL EXPOSURE; CANCER; MORTALITY; RATS; CARCINOGENICITY AB This study assessed the effect of chronic exposure to a 60 Hz circularly polarized magnetic field on the occurrence of ionizing radiation-induced lymphoma and other hematopoietic neoplasia in mice. Female C57BL/6 mice received lifetime exposure to either a magnetic field flux density of 1.42 mT for 18 h/day, or an ambient magnetic field of 0.13 mu T Beginning- on the first day of magnetic field exposure, 1710 mice were treated with one of three levels of split-dose Cobalt-60 gamma-radiation (cumulative 3.0, 4.0 or 5.1 Cy), The remaining 570 mice received sham irradiation treatment, Sections from 10 lymphoid tissues were evaluated histopathologically for hematopoietic neoplasia, The primary statistical analysis used the Poly3 method to compare lymphoma incidences in magnetic field (MF)-exposed and control mice. Secondary analyses used the Cox proportional hazards model to analyze incidence rates for mortality and development of specific types of neoplasia, The mortality incidence rate was increased by ionizing radiation treatment, and all neoplasms were observed sooner in irradiated mice. However, the lifetime incidence of hematopoietic neoplasia was similar in all experimental groups, including those that were not exposed to ionizing radiation. Chronic exposure to MFs did not affect the mortality incidence rates and did not change the relative incidences of hematopoietic neoplasia in mice that received the same ionizing radiation treatment, with the exception of a marginally significant reduced relative risk of 0.97 (P = 0.05) for lymphoblastic lymphoma in mice exposed to a magnetic field and treated with 5.1 Cy, Lymphomas and histiocytic sarcomas were first observed similar to 50 days sooner in mice that were exposed to magnetic fields but not ionizing radiation, although this comparison was not statistically significant and the incidence of hematopoietic neoplasia in these mice was not different from that of mice in the 0 T/0 Gy group. C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Radiol, Los Angeles, CA 90095 USA. St Vincents Med Ctr, Immunotherapy Lab, Los Angeles, CA 90057 USA. Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA. Merle Norman Cosmet, El Segundo, CA USA. VA Greater Los Angeles Healthcare Syst W Los Ange, Educ & Clin Ctr, Los Angeles, CA 90073 USA. Scirex Corp, Horsham, PA 19044 USA. RP Babbitt, JT (reprint author), Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. NR 53 TC 18 Z9 18 U1 0 U2 4 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0143-3334 J9 CARCINOGENESIS JI Carcinogenesis PD JUL PY 2000 VL 21 IS 7 BP 1379 EP 1389 DI 10.1093/carcin/21.7.1379 PG 11 WC Oncology SC Oncology GA 336QD UT WOS:000088313700015 PM 10874017 ER PT J AU Suratt, BT Welsh, CH AF Suratt, BT Welsh, CH TI A 48-year-old smoker with cough and weight loss SO CHEST LA English DT Article ID ACTINOMYCOSIS C1 Denver Vet Affairs Med Ctr, Denver, CO USA. RP Suratt, BT (reprint author), Univ Colorado, Hlth Sci Ctr, Div Pulm Sci & Crit Care Med, Box C272,4200 E 9th Ave, Denver, CO 80231 USA. FU NHLBI NIH HHS [T32 HL007085] NR 6 TC 3 Z9 3 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD JUL PY 2000 VL 118 IS 1 BP 239 EP 241 DI 10.1378/chest.118.1.239 PG 3 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 336CR UT WOS:000088284800042 PM 10893386 ER PT J AU Chandrasekar, B Melby, PC Troyer, DA Freeman, GL AF Chandrasekar, B Melby, PC Troyer, DA Freeman, GL TI Differential regulation of nitric oxide synthase isoforms in experimental acute Chagasic cardiomyopathy SO CLINICAL AND EXPERIMENTAL IMMUNOLOGY LA English DT Article DE Chagas' disease; Trypanosoma cruzi; cardiomyopathy; nitric oxide synthase; peroxynitrite ID TUMOR-NECROSIS-FACTOR; TRYPANOSOMA-CRUZI INFECTION; PROINFLAMMATORY CYTOKINE; EXPRESSION; INDUCTION; DISEASE; SUPEROXIDE; MICE; PEROXYNITRITE; RECEPTOR AB We have previously demonstrated induction and high level expression of IL-1 beta, IL-6 and tumour necrosis factor-alpha in the myocardium during the acute stage of experimental Trypanosoma cruzi infection (Chagas' disease). The myocardial depressive effects of these cytokines are mediated in part by the induction of nitric oxide synthase (NOS), production of nitric oxide (NO) and formation of peroxynitrite. In this study we investigated the expression, activity and localization of NOS isoforms, and the levels of NO, malondialdehyde (a measure of oxidative stress), and peroxynitrite in rats at 1.5, 5, 10 and 15 days after infection with T. cruzi trypomastigotes. The myocardial inflammatory infiltrate and number of amastigote nests increased over the course of infection. A significant increase in tissue nitrate + nitrite levels, NOS2 mRNA, and NOS2 enzyme activity was observed at all time points in the infected compared with uninfected animals. The enzyme activity of constitutive NOS, tissue malondialdehyde levels, and NOS3 mRNA levels was only transiently increased after infection. The protein levels of the NOS isoforms paralleled their mRNA expression. While no positive nitrotyrosine immunoreactivity was detected in control myocardium, its levels increased in infected animals over time. Thus, by 1.5 days post-infection, when no parasite or immune cell infiltration could be detected, the myocardium expressed high levels of NOS and NO metabolites. Nevertheless, the early production of NO in the myocardium was not sufficient to clear the parasites. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. Dept Vet Affairs Med Ctr, Med Serv, San Antonio, TX USA. RP Freeman, GL (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med Cardiol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 33 TC 29 Z9 29 U1 0 U2 1 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND SN 0009-9104 J9 CLIN EXP IMMUNOL JI Clin. Exp. Immunol. PD JUL PY 2000 VL 121 IS 1 BP 112 EP 119 DI 10.1046/j.1365-2249.2000.01258.x PG 8 WC Immunology SC Immunology GA 328NH UT WOS:000087856600017 PM 10886247 ER PT J AU Norman, DC AF Norman, DC TI Fever in the elderly SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID NURSING-HOME RESIDENTS; UNKNOWN ORIGIN; INFECTIVE ENDOCARDITIS; CLINICAL-SIGNIFICANCE; BACTEREMIA; AGE; TEMPERATURE; PROGNOSIS; FEATURES; PYREXIA AB Infections in the elderly, similar to other acute illnesses in this age group, may present in atypical, nonclassical fashions. Fever, the cardinal sign of infection, may be absent or blunted 20%-30% of the time. An absent or blunted fever response may in turn contribute to diagnostic delays in this population, which is already at risk for increased morbidity and mortality due to infection. On the other hand, the presence of a fever in the geriatric patient is more likely to be associated with a serious viral or bacterial infection than is fever in a younger patient. Finally, a diagnosis can be made in the majority of cases of fever of unknown origin (FUO) in the elderly. FUO is often associated with treatable conditions in this age group. C1 Univ Calif Los Angeles, Dept Med, Div Geriatr, Sch Med, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Norman, DC (reprint author), Vet Affairs Med Ctr W Los Angeles, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 42 TC 86 Z9 92 U1 3 U2 8 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 BP 148 EP 151 DI 10.1086/313896 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900028 PM 10913413 ER PT J AU Sutton, PR Harley, JD Jacobson, AF Lipsky, BA AF Sutton, PR Harley, JD Jacobson, AF Lipsky, BA TI Diagnosing osteomyelitis with percutaneous bone biopsy in patients with diabetes and foot ulceration. SO CLINICAL INFECTIOUS DISEASES LA English DT Meeting Abstract C1 VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 MA 30 BP 218 EP 218 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900080 ER PT J AU Hamill, RJ Pappas, PG Rex, JH Lee, JY Horowitz, H Kauffman, CA Hyslop, N Larsen, RA Stein, DK Graviss, EA Thomas, CJ AF Hamill, RJ Pappas, PG Rex, JH Lee, JY Horowitz, H Kauffman, CA Hyslop, N Larsen, RA Stein, DK Graviss, EA Thomas, CJ CA Mycoses Study Grp TI Multicenter surveillance of non-albicans candidemia SO CLINICAL INFECTIOUS DISEASES LA English DT Meeting Abstract C1 Univ Michigan, Ann Arbor VA Med Ctr, Ann Arbor, MI 48109 USA. Baylor Coll Med, Houston VA Med Ctr, Houston, TX 77030 USA. NIAID, Jacobi Med Ctr, Bethesda, MD 20892 USA. Tulane Univ, New Orleans, LA 70118 USA. Univ Alabama, Birmingham, AL USA. Univ So Calif, Los Angeles, CA USA. Univ Texas, Houston, TX USA. Westchester Cty Hosp, Valhalla, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 MA 36 BP 219 EP 219 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900086 ER PT J AU Omer, I Perfect, JR Warren, RM Hamill, RJ Kauffman, CA Pappas, PG AF Omer, I Perfect, JR Warren, RM Hamill, RJ Kauffman, CA Pappas, PG TI Cryptococcosis without central nervous system or pulmonary involvement in HIV-negative patients SO CLINICAL INFECTIOUS DISEASES LA English DT Meeting Abstract C1 Univ Michigan, Ann Arbor VA Med Ctr, Ann Arbor, MI 48109 USA. Duke Univ, Med Ctr, Durham, NC USA. Baylor Coll Med, Houston VA Med Ctr, Houston, TX 77030 USA. Univ Alabama, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 MA 39 BP 219 EP 219 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900089 ER PT J AU Musher, DM Phan, HM Mediwala, R Baughn, RE AF Musher, DM Phan, HM Mediwala, R Baughn, RE TI Human IgG to Pneumolysin (PLY) is protective in vivo against infection by Streptococcus pneumoniae (Spn) SO CLINICAL INFECTIOUS DISEASES LA English DT Meeting Abstract C1 VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 MA 117 BP 233 EP 233 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900167 ER PT J AU Ballard, JE Jernigan, DB O'Connor, S Strausbaugh, LJ Liedtke, LA Ashford, DA AF Ballard, JE Jernigan, DB O'Connor, S Strausbaugh, LJ Liedtke, LA Ashford, DA CA IDSA Emerging Infections Network TI Crohn's disease and possible infectious etiologies: Infectious disease consultants' views SO CLINICAL INFECTIOUS DISEASES LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA USA. Infect Dis Soc Amer, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 MA 154 BP 239 EP 239 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900204 ER PT J AU Darouiche, RO Hull, RA Donovan, WH AF Darouiche, RO Hull, RA Donovan, WH TI Bacterial interference for prevention of urinary tract infection (UTI). SO CLINICAL INFECTIOUS DISEASES LA English DT Meeting Abstract C1 Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. Univ Texas, Hlth Sci Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 MA 180 BP 244 EP 244 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900230 ER PT J AU Hanna, HA Alakech, B Chatzinikolaou, I Darouiche, RO Rolston, KV Whimbey, EE Hachem, RY Raad, II AF Hanna, HA Alakech, B Chatzinikolaou, I Darouiche, RO Rolston, KV Whimbey, EE Hachem, RY Raad, II TI Predictors of catheter-related bloodstream infections (CRBSI) in cancer patients with bacteremia or fungemia SO CLINICAL INFECTIOUS DISEASES LA English DT Meeting Abstract C1 Baylor Coll Med, VA Med Ctr, Houston, TX 77030 USA. Univ Texas, MD Anderson Canc Ctr, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 MA 414 BP 284 EP 284 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900464 ER PT J AU Strausbaugh, LJ Jernigan, DB Liedtke, LA Young, JC Khan, AS Ksiazek, TG AF Strausbaugh, LJ Jernigan, DB Liedtke, LA Young, JC Khan, AS Ksiazek, TG CA IDSA Emerging Infections Network TI Hantavirus pulmonary syndrome in the United States: Experience of infectious diseases consultants SO CLINICAL INFECTIOUS DISEASES LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA USA. Portland VA Med Ctr, Portland, OR USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 MA 495 BP 298 EP 298 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900545 ER PT J AU Restrepo, MI Bohorquez, M Restrepo, A Jorgensen, JH Anzueto, A Melby, PC AF Restrepo, MI Bohorquez, M Restrepo, A Jorgensen, JH Anzueto, A Melby, PC TI Antimicrobial susceptibility to Mycobacterial szulgai: 25-year experience SO CLINICAL INFECTIOUS DISEASES LA English DT Meeting Abstract C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Vet Adm Med Ctr, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 MA 573 BP 312 EP 312 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900623 ER PT J AU Murphy, MD Rosen, HR Chou, SW AF Murphy, MD Rosen, HR Chou, SW TI Hepatitis C virus NSSA sequence configuration does not predict response to interferon. SO CLINICAL INFECTIOUS DISEASES LA English DT Meeting Abstract C1 Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 2000 VL 31 IS 1 MA 617 BP 319 EP 319 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 347VY UT WOS:000088950900667 ER PT J AU Sjak-Shie, NN Vescio, RA Berenson, JR AF Sjak-Shie, NN Vescio, RA Berenson, JR TI Recent advances in multiple myeloma SO CURRENT OPINION IN HEMATOLOGY LA English DT Article ID STEM-CELL TRANSPLANTATION; BONE-MARROW TRANSPLANTATION; SARCOMA-ASSOCIATED HERPESVIRUS; IN-SITU HYBRIDIZATION; TUMOR-NECROSIS-FACTOR; HEPATOCYTE GROWTH-FACTOR; KAPOSIS-SARCOMA; UNDETERMINED SIGNIFICANCE; MONOCLONAL GAMMOPATHY; DENDRITIC CELLS AB Multiple myeloma is the second most common hematologic malignancy, with approximately 15,000 new cases each year in the United States. Our understanding of the pathophysiology underlying myeloma continues to expand, but the cause of this plasma cell dyscrasia remains unclear, Though controversy remains regarding a possible viral cause of myeloma, evidence suggesting a role for the human herpesvirus-8 is mounting, The roles of cytogenetic abnormalities as well as aberrant angiogenesis and cytokine expression in the etiology of myeloma continue to be explored and may lead to future therapeutic strategies. Transplantation in myeloma is rarely curative but offers clinical benefit not only for young but possibly for older myeloma patients as well. Newer bisphosphonates may offer greater ease of administration, improved efficacy, and possibly even enhanced antitumor effect. Finally, thalidomide offers significant clinical benefit to patients with myeloma previously refractory to multiple agents, and its role in early stages of the disease is under investigation. (C) 2000 Lippincott Williams & Wilkins, Inc. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Jonsson Comprehens Canc Ctr, Sch Med, Div Hematol & Oncol, Los Angeles, CA 90024 USA. RP Berenson, JR (reprint author), W Los Angeles Vet Affairs Med Ctr, 111 H,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 75 TC 8 Z9 9 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1065-6251 J9 CURR OPIN HEMATOL JI Curr. Opin. Hematol. PD JUL PY 2000 VL 7 IS 4 BP 241 EP 246 DI 10.1097/00062752-200007000-00007 PG 6 WC Hematology SC Hematology GA 379YW UT WOS:000165671600007 PM 10882180 ER PT J AU Freytes, CO AF Freytes, CO TI Indications and complications of intravenous devices for chemotherapy SO CURRENT OPINION IN ONCOLOGY LA English DT Review ID CENTRAL VENOUS CATHETERS; BLOOD-STREAM INFECTIONS; CANCER-PATIENTS; RANDOMIZED TRIAL; ACCESS DEVICES; PREVENTION; CULTURES; SYSTEMS; AGENTS AB Vascular access devices (VADs) are frequently used in patients with cancer. Vascular access devices can be divided into external catheters and subcutaneous venous access ports. Each type of device has its advantages and disadvantages, but the indications and optimal use of specific VADs remain to be defined. There are multiple complications of VADs but, with the exception of catheter-related bloodstream infections and thrombosis, most complications are rare. The use of VADs impregnated with antibiotic reduces the rates of catheter colonization and catheter-related bloodstream infections as compared with the use of unimpregnated catheters for short-term use. Thrombosis remains a major complication of VADs, and prospective, controlled studies are needed to clearly define the risk factors, natural history, and optimal treatment of this complication. Curr Opin Oncol 2000, 12:303-307 (C) 2000 Lippincott Williams & Wilkins, Inc. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Freytes, CO (reprint author), Univ Texas, Hlth Sci Ctr, Mail Code 7880,7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 16 TC 17 Z9 18 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-8746 J9 CURR OPIN ONCOL JI Curr. Opin. Oncol. PD JUL PY 2000 VL 12 IS 4 BP 303 EP 307 DI 10.1097/00001622-200007000-00005 PG 5 WC Oncology SC Oncology GA 357BU UT WOS:000089479300005 PM 10888414 ER PT J AU Inman, RD Whittum-Hudson, JA Schumacher, HR Hudson, AP AF Inman, RD Whittum-Hudson, JA Schumacher, HR Hudson, AP TI Chlamydia and associated arthritis SO CURRENT OPINION IN RHEUMATOLOGY LA English DT Review ID INDUCED REACTIVE ARTHRITIS; POLYMERASE-CHAIN-REACTION; REITERS-SYNDROME; SYNOVIAL TISSUE; TRACHOMATIS INFECTION; GENE-EXPRESSION; YERSINIA ANTIGENS; NUCLEIC-ACIDS; BACTERIAL-DNA; CELLS AB An inflammatory arthritis is known to follow urogenital infection with the intracellular bacterium Chlamydia trachomatis in some individuals, and recent research results have elucidated important aspects of the characteristics of this Chlamydia-associated joint disease. Although the several extra-articular features of Chlamydia-induced arthritis have been defined clinically, their detailed causes remain largely unexplained. Current data indicate that the clinical characteristics of joint disease associated with C, trachomatis infection and those associated with postenteric arthritis are not easily distinguishable, although the response of each to antibiotic therapy does differ. The biologic characteristics of Chlamydia and enteric organisms in the joint show profound differences, and these are probably responsible for the variable responses to drug treatment. Molecular analyses of synovial C. trachomatis have demonstrated that long-term infection of the joint occurs primarily in synovial tissue and that the organism exhibits highly unusual biologic properties in its synovial context. These unusual molecular, biochemical, and other characteristics provide explanations for the frequent culture negativity of joint materials for C. trachomatis and for several other aspects of the arthritogenic process. Much remains to be learned concerning the behavior of this organism in the joint and concerning its interaction with its synovial host cells. (C) 2000 Lippincott Williams & Wilkins, Inc. C1 Wayne State Univ, Sch Med, Dept Immunol & Microbiol, Detroit, MI 48201 USA. Univ Toronto, Dept Med, Toronto, ON, Canada. Univ Toronto, Dept Immunol, Toronto, ON, Canada. Wayne State Univ, Sch Med, Div Rheumatol, Dept Internal Med, Detroit, MI USA. Univ Penn, Sch Med, Div Rheumatol, Dept Med, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Arthritis & Immunol Ctr, Philadelphia, PA 19104 USA. RP Hudson, AP (reprint author), Wayne State Univ, Sch Med, Dept Immunol & Microbiol, Gordon H Scott Hall,540 E Canfield Ave, Detroit, MI 48201 USA. FU NIAID NIH HHS [AI-44493]; NIAMS NIH HHS [AR-42541] NR 81 TC 54 Z9 58 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-8711 J9 CURR OPIN RHEUMATOL JI CURR. OPIN. RHEUMATOL. PD JUL PY 2000 VL 12 IS 4 BP 254 EP 262 DI 10.1097/00002281-200007000-00004 PG 9 WC Rheumatology SC Rheumatology GA 329LT UT WOS:000087909000004 PM 10910176 ER PT J AU Zweiman, B Parrott, CM Graif, Y David, M Lessin, SR AF Zweiman, B Parrott, CM Graif, Y David, M Lessin, SR TI Quantitative comparison of cytokine mRNA and inflammatory responses in cutaneous late phase allergic reactions SO CYTOKINE LA English DT Article DE cutaneous late phase reactions; cytokine; IL-5; mRNA ID MESSENGER-RNA EXPRESSION; ADHESION MOLECULES; ATOPIC SUBJECTS; SKIN; IGE; EOSINOPHILS; IL-5; LYMPHOCYTES; CHALLENGE; CELLS AB The aim of this study was to quantitatively compare expression of mRNA for IL-5 and IFN-gamma with the frequency of mRNA-positive cells, total and activated eosinophils, neutrophils, lymphocytes, and vessels expressing adhesion molecules. Replicate biopsies of skin LPR to pollen antigens (Ag) and control injection sites (B) at 6 and 24 h were assessed for: (1) mRNA for IL-5 and IFN-gamma by quantitative RT-PCR (QC-RT/PCR); (2) frequency of cells expressing mRNA for IL-5 and IFN-gamma by in situ hybridization (ISH); (3) inflammatory cells and adhesion molecule expression. More mRNA for IL-5 was found in Ag- than in B-injected sites at 6 and 24 h by both QC-RT/PCR and ISH. Small amounts of mRNA for IFN-gamma were detected in Ag sites by QC-RT/PCR at 6 and 24 h, but mere not significantly different than at B sites. The frequency of IFN-gamma mRNA(+) cells was higher in Ag than in B sites at 6h, There was no correlation between the amount if IL-5 detected by QC-RT/PCR and frequency of IL-5 mRNA(+) cells by ISH, These findings also did not correlate with the degree of inflammatory responses. In conclusion: (1) greater IL-5 than IFN-gamma deposition in Ag sites suggests Th-2 predominance in LPR; (2) lack of correlation between QC-RT/PCR and ISH findings may reflect varying mRNA content of inflammatory cells. (C) 2000 Academic Press. C1 Univ Penn, Med Ctr, Dept Dermatol, Div Allergy & Immunol, Philadelphia, PA 19104 USA. Univ Penn, Med Ctr, Dept Internal Med, Div Allergy & Immunol, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Zweiman, B (reprint author), Univ Penn, Sch Med, Dept Allergy & Immunol, 512 Johnson Pavil, Philadelphia, PA 19104 USA. FU NCI NIH HHS [CA-55017]; NIAID NIH HHS [R01 AI-14332] NR 28 TC 2 Z9 2 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 1043-4666 J9 CYTOKINE JI Cytokine PD JUL PY 2000 VL 12 IS 7 BP 1065 EP 1075 DI 10.1006/cyto.2000.0671 PG 11 WC Biochemistry & Molecular Biology; Cell Biology; Immunology SC Biochemistry & Molecular Biology; Cell Biology; Immunology GA 335AY UT WOS:000088220900027 PM 10880253 ER PT J AU Jones, HE Johnson, RE Fudala, PJ Henningfield, JE Heishman, SJ AF Jones, HE Johnson, RE Fudala, PJ Henningfield, JE Heishman, SJ TI Nalmefene: blockade of intravenous morphine challenge effects in opioid abusing humans SO DRUG AND ALCOHOL DEPENDENCE LA English DT Article DE nalmefene; morphine; subjective effects; blockade; pharmacology ID BRAIN MEMBRANES; ORAL NALMEFENE; NALOXONE; DURATION; NALTREXONE; DISPOSITION; ANTAGONIST; DEPENDENCE; SEDATION; BINDING AB No studies have assessed the dose-effect or duration of opioid blockade in opioid abusers produced by oral nalmefene: a mu-opioid antagonist. The present study examined the profile and time course of oral nalmefene blockade of subjective and physiological effects produced by intravenous morphine. To assess these effects, seven opioid abusers received oral nalmefene (0, 50 and 100 mg) followed by intravenous morphine (0, 10 and 20 mg) challenges every 24 h for 96 h using a Latin square randomized cross-over design. The duration of blockade varied by measure and dose. Both 50 and 100 mg nalmefene blocked morphine's effects up to 48 h. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved. C1 NIDA, Intramural Res Program, Baltimore, MD 21224 USA. Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA. Johns Hopkins Univ, Sch Med, Ctr Addict & Pregnancy, Baltimore, MD 21224 USA. Univ Penn, Sch Med, Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Pinney Associates, Bethesda, MD USA. RP Heishman, SJ (reprint author), NIDA, Intramural Res Program, 5500 Nathan Shock Dr, Baltimore, MD 21224 USA. EM sheish@intra.nida.nih.gov NR 35 TC 2 Z9 4 U1 0 U2 0 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0376-8716 EI 1879-0046 J9 DRUG ALCOHOL DEPEN JI Drug Alcohol Depend. PD JUL 1 PY 2000 VL 60 IS 1 BP 29 EP 37 DI 10.1016/S0376-8716(99)00138-6 PG 9 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 320XC UT WOS:000087425300004 ER PT J AU Hahn, M Fennerty, MB Corless, CL Magaret, N Lieberman, DA Faigel, DO AF Hahn, M Fennerty, MB Corless, CL Magaret, N Lieberman, DA Faigel, DO TI Noninvasive tests as a substitute for histology in the diagnosis of Helicobacter pylori infection SO GASTROINTESTINAL ENDOSCOPY LA English DT Article; Proceedings Paper CT Annual Digestive Disease Week/97th Annual Meeting of the American-Gastroenterological-Association CY MAY 17-20, 1998 CL NEW ORLEANS, LOUISIANA SP Amer Gastroenterol Assoc ID NONULCER DYSPEPSIA; GOLD STANDARD; GASTRITIS; ACCURACY; BIOPSIES; SEROLOGY; CULTURE; BLOOD; ELISA AB Background: Rapid urease tests for Helicobacter pylori have a sensitivity of 80% to 90%. Therefore histologic examination of gastric biopsies is recommended as a "backup" diagnostic test in rapid urease test-negative patients. However, noninvasive tests (urea breath test, serology whole blood antibody tests) may provide a more rapid diagnosis and be less expensive but offer similar accuracy. Methods: Sixty-seven patients (no prior treatment for H pylori, no proton pump inhibitors, antibiotics, or bismuth within 4 weeks) undergoing endoscopy for evaluation of dyspepsia symptoms and testing rapid urease test-negative by antral biopsy were enrolled. All had the following tests: gastric biopsies (2 antral, 1 fundus; H&E and Alcian Yellow stain) examined for gastritis and H pylori;C-13-UBT; capillary blood for whole blood rapid antibody tests: FlexSure HP, QuickVue, AccuStat, and Stat-Simple Pylori; serum for FlexSure HP; HM-CAP enzyme-linked immunoassay. H pylori infection was diagnosed (reference standard) if chronic gastritis was present on histology and at least 2 of the 3 following tests were positive: urea breath test, H pylori organisms unequivocally demonstrated in biopsies on special stain, and/or enzyme-linked immunoassay. The test and treatment costs per patient were calculated. Results: Of 67 patients with a negative rapid urease test, 4 were positive for H pylori. None had active peptic ulcer disease. Histology only identified 1 patient with organisms visible on special stain. Using chronic active gastritis (neutrophilic and mononuclear infiltrate) as a diagnostic criterion for H pylori, 6 patients would have been judged positive. However, only 2 of these were truly positive by the reference standard (positive predictive value 33%). Negative predictive value for presence of organisms and chronic active gastritis was 95% and 97%, respectively. All of the noninvasive tests identified all 4 truly positive patients correctly. Urea breath test and FlexSure whole blood assay yielded a substantial number of false-positive results (positive predictive value 31% and 36%, respectively); positive predictive value for the other tests ranged from 50% to 80%. All tests except histology had a negative predictive value of 100%. Histology was the most costly test (p < 0.001 compared with all other tests), followed by urea breath test and HM-CAP serology (p < 0.001 compared with all rapid antibody tests). Conclusions: Whole blood or serum antibody testing is a rapid, accurate, and cost-effective means for establishing H pylori status in rapid urease test-negative patients. Whole blood or serology rapid antibody testing should substitute for histology when the patient has not been previously treated for H pylori. C1 Portland VA Med Ctr, Div Gastroenterol, Portland, OR 97201 USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. RP Faigel, DO (reprint author), Portland VA Med Ctr, Div Gastroenterol, P3GI,3710 SW US Vet Hosp Rd, Portland, OR 97201 USA. NR 25 TC 25 Z9 27 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD JUL PY 2000 VL 52 IS 1 BP 20 EP 26 DI 10.1067/mge.2000.106686 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 334PZ UT WOS:000088196000005 PM 10882957 ER PT J AU Saha, S Taggart, SH Komaromy, M Bindman, AB AF Saha, S Taggart, SH Komaromy, M Bindman, AB TI Do patients choose physicians of their own race? To provide the kind of care consumers want, medical schools might be able to justify using race as an admissions criterion. SO HEALTH AFFAIRS LA English DT Article ID HEALTH-CARE; MINORITY AB This study seeks to determine whether minority America ns tend to see physicians of their own race as a matter of choice or simply because minority physicians are more conveniently located within predominantly minority communities. Using data from the Commonwealth Fund 1994 National Comparative Survey of Minority Health Care, we found that black and Hispanic Americans sought care from physicians of their own race because of personal preference and language, not solely because of geographic accessibility. As minority populations continue to grow, the demand for minority physicians is likely to increase. Keeping up with this demand will require medical school admissions policies and physician workforce planning to include explicit strategies to increase the supply of underrepresented minority physicians. C1 Portland Vet Affairs Med Ctr, Portland, OR USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Univ Washington, Ctr Reinventing Publ Educ, Seattle, WA 98195 USA. Univ Calif San Francisco, Primary Care Res Ctr, San Francisco, CA 94143 USA. San Francisco Gen Hosp, Div Gen Internal Med, San Francisco, CA USA. RP Saha, S (reprint author), Portland Vet Affairs Med Ctr, Portland, OR USA. NR 19 TC 172 Z9 172 U1 0 U2 2 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD JUL-AUG PY 2000 VL 19 IS 4 BP 76 EP 83 DI 10.1377/hlthaff.19.4.76 PG 8 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 335KM UT WOS:000088242700008 PM 10916962 ER PT J AU Carey, K AF Carey, K TI A multilevel modelling approach to analysis of patient costs under managed care SO HEALTH ECONOMICS LA English DT Article DE patient costs; multilevel modelling; managed care ID HIERARCHICAL LINEAR-MODELS; STOCHASTIC FRONTIER; HEALTH ECONOMICS; EFFICIENCY AB The growth of the managed care model of health care delivery in the USA has led to broadened interest in the performance of health care providers. This paper uses multilevel modelling to analyse the effects of managed care penetration on patient level costs for a sample of 24 medical centres operated by the Veterans Health Administration (VHA). The appropriateness of a two level approach to this problem over ordinary least squares (OLS) is demonstrated. Results indicate a modicum of difference in institutions' performance after controlling for patient effects. Facilities more heavily penetrated by the managed care model may be more effective at controlling costs of their sicker patients. Published in 2000 by John Wiley & Sons, Ltd. C1 US Dept Vet Affairs, Management Sci Grp, Bedford, MA 01730 USA. Boston Univ, Sch Publ Hlth, Boston, MA USA. RP Carey, K (reprint author), US Dept Vet Affairs, Management Sci Grp, Bldg 12,200 Springs Rd, Bedford, MA 01730 USA. NR 28 TC 40 Z9 40 U1 0 U2 7 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 1057-9230 J9 HEALTH ECON JI Health Econ. PD JUL PY 2000 VL 9 IS 5 BP 435 EP 446 DI 10.1002/1099-1050(200007)9:5<435::AID-HEC523>3.0.CO;2-Z PG 12 WC Economics; Health Care Sciences & Services; Health Policy & Services SC Business & Economics; Health Care Sciences & Services GA 342UZ UT WOS:000088664700007 PM 10903543 ER PT J AU Cooper, RA Boninger, ML AF Cooper, RA Boninger, ML TI Encouraging students with disabilities to pursue careers in bioengineering SO IEEE ENGINEERING IN MEDICINE AND BIOLOGY MAGAZINE LA English DT Editorial Material C1 Univ Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Med Ctr Hlth Syst, Dept Phys Med & Rehabil, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Med Ctr Hlth Syst, Dept Orthopaed Surg, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15260 USA. RP Cooper, RA (reprint author), VA Pittsburgh Healthcare Syst, Human Engn Res Labs 151 R1, 7180 Highland Dr, Pittsburgh, PA 15206 USA. OI Boninger, Michael/0000-0001-6966-919X NR 3 TC 0 Z9 0 U1 0 U2 0 PU IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC PI NEW YORK PA 345 E 47TH ST, NEW YORK, NY 10017-2394 USA SN 0739-5175 J9 IEEE ENG MED BIOL JI IEEE Eng. Med. Biol. Mag. PD JUL-AUG PY 2000 VL 19 IS 4 BP 9 EP 12 PG 4 WC Engineering, Biomedical; Medical Informatics SC Engineering; Medical Informatics GA 336WG UT WOS:000088325500003 PM 10916726 ER PT J AU Cooper, RA Jones, DK Fitzgerald, S Boninger, ML Albright, SJ AF Cooper, RA Jones, DK Fitzgerald, S Boninger, ML Albright, SJ TI Analysis of position and isometric joysticks for powered wheelchair driving SO IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING LA English DT Article DE Fitts' law; human-machine control; information processing; modeling; wheelchair ID FITTS LAW; MOVEMENTS; HAND AB The control interface is one of the most critical components of the electric-powered wheelchair (EPW). The control interface must accommodate the user's limitations and maximize the user's abilities. This study extended Fitts' Law for target-acquisition to a continuously updated target. The extended Fitts' Law was used to examine EPW driving with a standard position sensing joystick and a prototype isometric joystick (IJ). The extended Fitts' Law provides insight into the difficulty of performing target-acquisition tasks with an EPW. The test results showed significant differences (p < 0.05) among the two types of joysticks for selected measures of information processing capacity, movement time, root-mean-square-error, and average velocity while performing turning maneuvers. The mean values indicate that the IJ may provide superior turning performance. C1 Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Phys Med & Rehabil, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Mech Engn, Pittsburgh, PA 15206 USA. VA Pittsburgh Healthcare Syst, Human Engn Res Labs, VA Rehabil Res & Dev Ctr, Pittsburgh, PA 15206 USA. Cent Michigan Univ, Ind & Engn Technol Dept, Mt Pleasant, MI 48859 USA. RP Cooper, RA (reprint author), Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA 15206 USA. OI Boninger, Michael/0000-0001-6966-919X NR 27 TC 34 Z9 34 U1 0 U2 3 PU IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC PI NEW YORK PA 345 E 47TH ST, NEW YORK, NY 10017-2394 USA SN 0018-9294 J9 IEEE T BIO-MED ENG JI IEEE Trans. Biomed. Eng. PD JUL PY 2000 VL 47 IS 7 BP 902 EP 910 DI 10.1109/10.846684 PG 9 WC Engineering, Biomedical SC Engineering GA 327KV UT WOS:000087793800009 PM 10916261 ER PT J AU Patterson, JE Hardin, TC Kelly, CA Garcia, RC Jorgensen, JH AF Patterson, JE Hardin, TC Kelly, CA Garcia, RC Jorgensen, JH TI Association of antibiotic utilization measures and control of multiple-drug resistance in Klebsiella pneumoniae SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT 36th Annual Meeting of the Infectious-Diseases-Society-of-America CY NOV 12-15, 1998 CL DENVER, COLORADO SP Infect Dis Soc Amer ID SPECTRUM BETA-LACTAMASES; ENTEROBACTERIACEAE; ELECTROPHORESIS; RESTRICTION; OUTBREAK; PATTERNS AB OBJECTIVE: To study the association of antibiotic-utilization measures and control of multidrug-resistant (MDR) Klebsiella pneumoniae after emergence in two hospitals in our medical center. DESIGN AND SETTING: Rates of MDR K pneumoniae at two hospitals were compared before and after acute interventions, including emphasis on Contact Precautions and education in antibiotic utilization. Antipseudomonal beta-lactam antibiotic use was measured before and after the interventions at both hospitals. Pulsed-field gel electrophoresis of whole cell DNA was used as a marker of strain identity. RESULTS: Clonal strain dissemination was the major mechanism of emergence at hospital A ; emergence was polyclonal at hospital B. Antibiotic-utilization interventions at both institutions included physician education regarding the association of ceftazidime use and MDR K pneumoniae. At hospital a ceftazidime use decreased from 4,301g in the preintervention period, to 1,248 g in the postintervention period. Piperacillin-tazobactam increased from 12,455 g to 17,464 g. Ceftazidime resistance in K pneumoniae decreased from 110 (22%) of 503 isolates to 61 (15%) of 407 isolates (P<.05); piperacillin-tazobactam resistance decreased from 181 (36%) of 503 to 77 (19%) of 407 isolates (P<.05). At hospital B, ceftazidime use decreased from 6,533 g in the preintervention period to 4,792 g in the postintervention period. Piperacillin-tazobactam use increased from 58,691 g to 67,027 g. Ceftazidime resistance in K pneumoniae decreased from 42 (10%) of 415 isolates to 19 (5%) of 383 isolates (P<.05). Piperacillin-tazobactam resistance decreased from 91 (22%) of 415 isolates to 54 (14%) of 383 isolates (P<.05). Follow-up data showed continued decrease in piperacillin-tazobactam resistance despite increased use at both hospitals. CONCLUSIONS: Antibiotic-use measures may be particularly important for control of MDR K pneumoniae, whether emergence is clonal or polyclonal. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Patterson, JE (reprint author), Dept Med Infect Dis, 7703 Floyd Curl Dr,Mail Code 7881, San Antonio, TX 78229 USA. NR 13 TC 104 Z9 116 U1 0 U2 1 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD JUL PY 2000 VL 21 IS 7 BP 455 EP 458 DI 10.1086/501787 PG 4 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 335WG UT WOS:000088267300010 PM 10926395 ER PT J AU Pahlavani, MA Vargas, DA AF Pahlavani, MA Vargas, DA TI Activation-induced apoptosis in T cells from young and old Fischer 344 rats SO INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY LA English DT Article DE T cell; apoptosis; CD95; CD95L; Bax; Bcl-2; rat; aging ID FAS ANTIGEN; DNA FRAGMENTATION; OXIDATIVE STRESS; PERIPHERAL-BLOOD; DEATH APOPTOSIS; EXPRESSION; AGE; RECEPTOR; MICE; ENDONUCLEASE AB Background: Activation-induced apoptosis is believed to limit cell proliferation and eliminate the high number of activated cells during an immune response. Methods: Activation-induced apoptosis was investigated in splenic T cells isolated from young (6 months) and old (24 months) male Fischer 344 rats. The cells were incubated with anti-CD3, concanavalin A or staphylococcal enterotoxin B (primary stimulus) for 72 h, followed by restimulation with anti-CDB or concanavalin A (secondary stimulus). Apoptosis was assessed by DNA fragmentation assay and DNA gel electrophoresis. The expression of the apoptotic marker CD95 was analyzed by flow cytometry and the relative levels of CD95 ligand, Bcl-2 and Bax protein were measured by immunoblotting. Results: It was shown that DNA fragmentation was very low in the unstimulated T cells from both young and old rats. However, the level of DNA fragmentation was 45-55% great er in the activated T cells from old rats than in the activated T cells from young rats. The increase in DNA fragmentation was paralleled by an increase in the proportion of cells expressing the CD95 molecule. The proportion of CD95+ cells was approximately 40% higher in T cells from old rats than in T cells from young rats. In addition, it was found that the expression of CD95 ligand and Bax increased and Bcl-2 decreased in the activated T cells from old rats compared to the activated T cells from young rats. Conclusion: Our data suggest that the increase in sensitivity of T cells to apoptosis with age may contribute to age-associated immune dysfunction and disorders. Copyright (C) 2000 S. Karger AG, Basel. C1 Audie L Murphy Mem Vet Adm Med Ctr, GRECC 182, S Texas Vet Hlth Care Syst, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. RP Pahlavani, MA (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, GRECC 182, S Texas Vet Hlth Care Syst, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. FU NIA NIH HHS [AG00677, AG14088] NR 52 TC 4 Z9 4 U1 0 U2 0 PU KARGER PI BASEL PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND SN 1018-2438 J9 INT ARCH ALLERGY IMM JI Int. Arch. Allergy Immunol. PD JUL PY 2000 VL 122 IS 3 BP 182 EP 189 DI 10.1159/000024395 PG 8 WC Allergy; Immunology SC Allergy; Immunology GA 340LQ UT WOS:000088535000004 PM 10899761 ER PT J AU Childs, HA Spencer, SA Raben, D Bonner, JA Newsome, J Robert, F AF Childs, HA Spencer, SA Raben, D Bonner, JA Newsome, J Robert, F TI A phase I study of combined uft plus leucovorin and radiotherapy for pancreatic cancer SO INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS LA English DT Article; Proceedings Paper CT 41st Annual Meeting of the American-Society-for-Therapeutic-Radiology-and-Oncology CY OCT 30-NOV 04, 1999 CL SAN ANTONIO, TEXAS SP Amer Soc Therapeut Radiol & Oncol DE pancreatic; UFT; leucovorin; radiation ID COOPERATIVE-ONCOLOGY-GROUP; RADIATION-THERAPY; COLORECTAL-CANCER; ORAL REGIMEN; 5-FLUOROURACIL; CARCINOMA; FLUOROURACIL; FTORAFUR; INFUSION; URACIL AB Purpose: This Phase I study combines tegafur and uracil (UFT) with leucovorin and conventional radiation for the treatment of pancreatic cancer. The design seeks to determine the maximum tolerated dose (MTD) and dose-limiting toxicities (DLT) of this regimen as well as to define a future Phase II dose level. Methods: Patients with locally advanced and unresectable pancreatic cancer were treated with 45 Gy of radiation therapy. The initial UFT dose was 150 mg/m(2)/day given with leucovorin 90 mg/day, both divided into 3 daily doses for 35 days concurrent with radiation. UFT doses were escalated at increments of 50 mg/m(2)/day. Dose-limiting toxicity (DLT) was defined as Grade 3 or greater nausea, vomiting or diarrhea despite medical intervention; or Grade 3 or greater neutropenia/thrombocytopenia; or Grade 3 or greater hepatic toxicity; or inability of the patient to take 75% or more of the planned UFT/leucovorin; or radiotherapy interruption of greater than 1 week. The MTD for UFT/leucovorin was exceeded by one dose level when a certain dose caused DLT in 2 or more patients of 6. Results: Five evaluable patients had Stage I resectable disease but had pathologic adenopathy. Seven had Stage II unresectable disease. Compliance with therapy was excellent. At a daily dose of 300 mg/m(2) of UFT, we noticed minimal diarrhea and hematologic toxicity with mild-moderate nausea, anorexia, and fatigue. Three patients had Grade 4 toxicity: 1 had neutropenia on Day 38, 1 had diarrhea on Day 55, and 1 had vomiting on Day 15. Conclusion: Oral UFT/leucovorin and radiation therapy offers patients a viable treatment option for pancreatic cancer. The major known toxicity of diarrhea was tolerable. The MTD was not reached in this study. Our current plan is to expand this into a Phase I/II trial beginning at a UFT dose of 300 mg/m(2) and correlate this with clinical pharmacologic parameters. The potential benefit of long bioavailability and oral delivery of UFT compares favorably with continuous infusion regimens without the added morbidity of a catheter and pump. (C) 2000 Elsevier Science Inc. C1 Univ Alabama, Birmingham Comprehens Canc Ctr, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Birmingham, AL USA. RP Robert, F (reprint author), Univ Alabama, Birmingham Comprehens Canc Ctr, 1824 6th Ave S,236 TI, Birmingham, AL 35294 USA. NR 25 TC 18 Z9 19 U1 1 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0360-3016 J9 INT J RADIAT ONCOL JI Int. J. Radiat. Oncol. Biol. Phys. PD JUL 1 PY 2000 VL 47 IS 4 BP 939 EP 944 DI 10.1016/S0360-3016(00)00496-X PG 6 WC Oncology; Radiology, Nuclear Medicine & Medical Imaging SC Oncology; Radiology, Nuclear Medicine & Medical Imaging GA 328HV UT WOS:000087845500012 PM 10863063 ER PT J AU Chen, J Simon, RP Nagayama, T Zhu, R Loeffert, E Watkins, SC Graham, SH AF Chen, J Simon, RP Nagayama, T Zhu, R Loeffert, E Watkins, SC Graham, SH TI Suppression of endogenous bcl-2 expression by antisense treatment exacerbates ischemic neuronal death SO JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM LA English DT Article DE cerebral ischemia; bcl-2; antisense ID PROGRAMMED CELL-DEATH; TRANSIENT FOREBRAIN ISCHEMIA; CEREBRAL-ARTERY OCCLUSION; DNA FRAGMENTATION; GLOBAL-ISCHEMIA; GENE; RAT; PROTEIN; BAX; HIPPOCAMPUS AB Previous studies have shown that overexpression of bcl-2 in transgenic mice or by viral vectors protects the brain against cerebral ischemia. However, it is not known whether bcl-2, which is endogenously expressed in response to ischemia, exerts a protective effect. To address this question, the authors blocked the endogenous expression of bcl-2 after ischemia using antisense oligodeoxynucleotides (ODN). Antisense, sense, scrambled ODN, or vehicles were infused in the lateral ventricle of the rat for 24 hours after 30 minutes of temporary middle cerebral artery occlusion. Twenty-four hours later the brains were removed and bcl-2 protein expression was assayed by Western blot. Antisense ODN, but not sense or scrambled ODN treatment, significantly inhibited bcl-2 protein expression after ischemia. Bcl-2 protein expression was also studied 24 hours after 60 minutes of temporary middle cerebral artery occlusion in vehicle and antisense ODN-treated rats. After 60 minutes of ischemia and vehicle treatment, bcl-2 was expressed in many neurons in the ventral cortical mantle and the medial striatum. After antisense ODN treatment there were few neurons in this region expressing bcl-2, instead most neurons TUNEL labeled. Treatment with the antisense ODN, but not sense ODN, increased infarction volume as determined by cresyl violet staining 72 hours after ischemia compared with vehicle controls. These results suggested that endogenously expressed bcl-2 promoted survival in ischemic neurons and was not simply an epiphenomenon in neurons already destined to live or die. C1 Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Ctr Biol Imaging, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Cell Biol & Physiol, Pittsburgh, PA 15213 USA. Vet Affairs Pittsburgh Hlth Ctr, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Graham, SH (reprint author), Univ Pittsburgh, Dept Neurol, 526 South BST, Pittsburgh, PA 15213 USA. FU NINDS NIH HHS [P01 NS35965, R01 NS24728] NR 31 TC 56 Z9 63 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0271-678X J9 J CEREBR BLOOD F MET JI J. Cereb. Blood Flow Metab. PD JUL PY 2000 VL 20 IS 7 BP 1033 EP 1039 PG 7 WC Endocrinology & Metabolism; Hematology; Neurosciences SC Endocrinology & Metabolism; Hematology; Neurosciences & Neurology GA 329NX UT WOS:000087914200002 PM 10908036 ER PT J AU Fihn, SD Schleyer, AM Kelly-Hedrick, H Martin, DB AF Fihn, SD Schleyer, AM Kelly-Hedrick, H Martin, DB TI Effects of the revised HCFA evaluation and management guidelines on inpatient teaching SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 22nd Annual Meeting of the Society-of-General-Internal-Medicine CY APR 29-MAY 01, 1999 CL SAN FRANCISCO, CALIFORNIA SP Soc Gen Internal Med DE medical education; teaching; Medicare AB OBJECTIVE: In 1996, the Health Care Financing Administration (HCFA) introduced new evaluation and management (E&M) guidelines mandating more intensive supervision and documentation by attending physicians. We assessed the effects of the guidelines on inpatient teaching. DESIGN: Pretest-posttest, nonequivalent control group design. SETTING: A university hospital and an affiliated county hospital where the guidelines were implemented and an affiliated VA medical center where they were not. PARTICIPANTS: Sixty-one full-time faculty who had attended on the general medical wards for at least 1 month for 2 of 3 consecutive years prior to July 1996 and for at least 1 month during the 18 following months. MEASUREMENTS AND MAIN RESULTS: We evaluated standardized, confidential evaluations of attending physicians that are routinely completed by residents and students after clinical rotations at all three sites. Comparing 863 evaluations completed before July 1, 1996 and 497 completed after that date, there were no significant differences at any of the hospitals on any items assessed. There were also no differences between the university and county hospitals as compared with the VA. Eighty-seven percent of 39 university and county attending physicians returned a survey about their perceptions of inpatient teaching activities before and after July 1, 1996. They reported highly significant increases in time devoted to attending responsibilities but diminished time spent on teaching activities. CONCLUSIONS: Physicians reported a dramatic increase in overall time spent attending but a decrease in time spent teaching following implementation of the revised E&M guidelines. Yet, evaluations of their teaching effectiveness did not change. C1 VA Puget Sound Hlth Care Syst, Ctr Excellence 152, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98195 USA. RP Fihn, SD (reprint author), VA Puget Sound Hlth Care Syst, Ctr Excellence 152, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 9 TC 9 Z9 9 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JUL PY 2000 VL 15 IS 7 BP 451 EP 456 DI 10.1046/j.1525-1497.2000.07001.x PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 336LL UT WOS:000088302700002 PM 10940130 ER PT J AU Reue, K Xu, P Wang, XP Slavin, BG AF Reue, K Xu, P Wang, XP Slavin, BG TI Adipose tissue deficiency, glucose intolerance, and increased atherosclerosis result from mutation in the mouse fatty liver dystrophy (fld) gene SO JOURNAL OF LIPID RESEARCH LA English DT Article DE lipodystrophy; gene expression; insulin resistance; lipoproteins ID DENSITY-LIPOPROTEIN LEVELS; INSULIN-RESISTANCE; TRANSGENIC MICE; ADIPOCYTE DIFFERENTIATION; DIABETES-MELLITUS; RAT ADIPOCYTES; MESSENGER-RNA; MUTANT MOUSE; LIPASE; EXPRESSION AB The fatty liver dystrophy (fld) mutant mouse is characterized by neonatal fatty liver and hypertriglyceridemia that resolve at weaning, and neuropathy affecting peripheral nerve in adulthood. We now report additional significant manifestations of this single gene mutation, which include adipose tissue deficiency, glucose intolerance, and increased susceptibility to atherosclerosis. In adult fld/fld mice, both white and brown fat pads exhibit an 80% reduction in mass compared with wild-type controls, and consist of immature adipocytes as assessed by morphological and molecular criteria. The lack of Lipid accumulation in fld/fld adipose tissue could be attributed, in part, to a failure to induce expression of lipoprotein lipase and enzymes involved in fatty acid synthesis, such as fatty acid synthase and acetyl-CoA carboxylase. Related to the deficiency of adipose tissue, fld/fld mice were also found to exhibit profound glucose intolerance, modest hyperinsulinemia, and reduced tissue response to insulin. As insulin resistance is a important risk factor in vascular disease, we examined susceptibility of fld/fld mice to diet-induced atherosclerosis. Mutant mice fed an atherogenic diet developed 2-fold greater aortic lesions than their wild-type counterparts, despite having a less atherogenic lipoprotein cholesterol profile. The fld adipose-deficient phenotype has both similarities to and distinctions from the group of rare human diseases known as lipodystrophies. C1 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ So Calif, Dept Cell & Neurobiol, Los Angeles, CA 90033 USA. RP Reue, K (reprint author), Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90095 USA. FU NHLBI NIH HHS [HL-28481] NR 61 TC 110 Z9 114 U1 1 U2 2 PU LIPID RESEARCH INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0022-2275 J9 J LIPID RES JI J. Lipid Res. PD JUL PY 2000 VL 41 IS 7 BP 1067 EP 1076 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 335GZ UT WOS:000088236900005 PM 10884287 ER PT J AU Kampman, KM Rukstalis, M Pettinati, H Muller, E Acosta, T Gariti, P Ehrman, R O'Brien, CP AF Kampman, KM Rukstalis, M Pettinati, H Muller, E Acosta, T Gariti, P Ehrman, R O'Brien, CP TI The combination of phentermine and fenfluramine reduced cocaine withdrawal symptoms in an open trial SO JOURNAL OF SUBSTANCE ABUSE TREATMENT LA English DT Article ID PROGRESSIVE RATIO SCHEDULE; INTRAVENOUS COCAINE; DOUBLE-BLIND; BROMOCRIPTINE; AMANTADINE; DEPENDENCE; DECREASES; RECEPTORS; POINTS; DRUGS C1 Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Kampman, KM (reprint author), Univ Penn, Sch Med, Dept Psychiat, 3900 Chestnut St, Philadelphia, PA 19104 USA. FU NIDA NIH HHS [Y01 DA 30012, K20 DA 00238] NR 24 TC 17 Z9 17 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0740-5472 J9 J SUBST ABUSE TREAT JI J. Subst. Abus. Treat. PD JUL PY 2000 VL 19 IS 1 BP 77 EP 79 DI 10.1016/S0740-5472(99)00076-8 PG 3 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 328HG UT WOS:000087844200011 PM 10867304 ER PT J AU Behroozan, DS Christian, MM Moy, RL AF Behroozan, DS Christian, MM Moy, RL TI Short-pulse carbon dioxide laser resurfacing of the neck SO JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY LA English DT Article ID PHOTOAGED FACIAL SKIN; RHYTIDES; CO2-LASER; SCARS AB Background: Carbon dioxide (CO2) laser resurfacing of the face has become an increasingly popular procedure. However, laser resurfacing of the neck has been largely avoided because of fears of scarring or pigmentation changes. Objective: Our purpose was to evaluate the efficacy of treatment and incidence of complications after short-pulse CO2 laser resurfacing of the neck. Methods: A total of 308 patients received concomitant face and neck CO2 laser resurfacing. A 90 -mu s pulse duration CO2 laser without a scanner was used in all cases for 2 passes on the neck (10.6-mu m wavelength, 500-mJ pulse energy, 90-mu s duration, 3-mm spot size) and a continuous CO2 laser with a computer-generated scanner (396-mu s dwell time, 18 W) was used for 3 passes over the face except for the perioral area, which received 4 passes. The incidence of scarring or permanent pigmentation changes was determined. Forty patients who had been treated at least 6 months but no longer than 18 months earlier were randomly surveyed by phone to assess the degree of improvement. Results: Of the 308 patients treated, there were no cases of scarring or permanent pigmentation changes. Surveyed patients reported a 39% improvement in rhytides and tightening on the neck. Conclusion: Resurfacing of the neck can be performed safely in conjunction with resurfacing of the face. Patients may be offered improvement in the neck with little chance of scarring or permanent pigmentary changes when resurfacing on the neck is performed by means of a short-pulse duration laser for a limited number of passes instead of the more aggressive laser parameters previously used such as continuous long-pulse duration treatments. C1 Univ Calif Los Angeles, Los Angeles, CA USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Moy, RL (reprint author), 100 UCLA Med Plaza,Suite 590, Los Angeles, CA 90024 USA. NR 18 TC 9 Z9 9 U1 0 U2 1 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0190-9622 J9 J AM ACAD DERMATOL JI J. Am. Acad. Dermatol. PD JUL PY 2000 VL 43 IS 1 BP 72 EP 76 DI 10.1067/mjd.2000.104795 PN 1 PG 5 WC Dermatology SC Dermatology GA 329RW UT WOS:000087922500011 PM 10863227 ER PT J AU Hazzard, WR AF Hazzard, WR TI So you think you want to lead an academic geriatric program? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article C1 Wake Forest Univ, Sch Med, J Paul Sticht Ctr Aging, Winston Salem, NC 27109 USA. RP Hazzard, WR (reprint author), VA Puget Sound Hlth Care Syst, S-182-GEC, Seattle, WA 98108 USA. NR 5 TC 2 Z9 3 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUL PY 2000 VL 48 IS 7 BP 835 EP 841 PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 333HK UT WOS:000088124700019 PM 10894326 ER PT J AU Velmahos, GC Kern, J Chan, LS Oder, D Murray, JA Shekelle, P AF Velmahos, GC Kern, J Chan, LS Oder, D Murray, JA Shekelle, P TI Prevention of venous thromboembolism after injury: An evidence-based report - Part I: Analysis of risk fastors and evaluation of the role of vena caval filters SO JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE LA English DT Article ID MOLECULAR-WEIGHT HEPARIN; SPINAL-CORD INJURY; DEEP-VEIN THROMBOSIS; LOW-DOSE HEPARIN; ORTHOPEDIC TRAUMA PATIENTS; COMPRESSION DEVICES; MULTIPLE TRAUMA; CLINICAL-TRIALS; MAJOR TRAUMA; PROPHYLAXIS AB Background: Trauma surgeons use a variety of methods to prevent venous thromboembolism (VT), The rationale for their use frequently is based on conclusions from research on nontrauma populations. Existing recommendations are based on expert opinion and consensus statements rather than systematic analysis of the existing literature and synthesis of available data. The objective is to produce an evidence-based report on the methods of prevention of VT after injury. Methods: A panel of 17 national authorities from the academic, private, and managed care sectors helped design and review the project. We searched three electronic databases (MEDLINE, EMBASE, and Cochrane Controlled Trial Register) to identify articles relevant to four key questions: methods of prophylaxis, methods of screening, risk factors for VT, and the role of vena caval filters. The initial 4,093 titles yielded 73 articles for meta-analysis, A random-effects model was used for all pooled results. Study quality was evaluated by previously published quality scores. In this article (part I), we report on the question ranked by the experts as the most important, i.e., Which is the best method to prevent VT?, and also on the incidence of deep venous thrombosis and pulmonary embolism in trauma patients. Results:The incidence of deep venous thrombosis and pulmonary embolism reported in different studies varies widely. The pooled rates are 11.8% for deep venous thrombosis and 1.5% for pulmonary embolism. Only a few randomized controlled trials have evaluated the methods of VT prophylaxis among trauma patients, and combining their data is difficult because of different designs and preventive methods used. The quality of most studies is low, Meta-analysis shows no evidence that low-dose heparin, mechanical prophylaxis, or low-molecular-weight heparin are more effective than no prophylaxis or each other. However, the 95% confidence intervals of many of the comparisons are wide; therefore, a clinically important difference may exist. Conclusion: The trauma literature on VT prophylaxis provides inconsistent data. There is no evidence that any existing method of VT prophylaxis is clearly superior to the other methods or even to no prophylaxis, Our results cast serious doubt on the existing policies on VT prophylaxis, and we call for a large, high-quality, multicenter trial that can provide definitive answers. C1 Univ So Calif, Los Angeles Cty Med Ctr, Div Res & Biostat, Los Angeles, CA 90033 USA. Univ So Calif, Dept Surg, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Dept Clin Pharm, Los Angeles, CA 90033 USA. Univ So Calif, Sch Pharm, Los Angeles, CA 90033 USA. Greater Los Angeles VA Hlth Care Syst, Santa Monica, CA USA. RAND Corp, Santa Monica, CA USA. RP Velmahos, GC (reprint author), Univ So Calif, Los Angeles Cty Med Ctr, Div Res & Biostat, 1200 N State St,Room 9900, Los Angeles, CA 90033 USA. FU PHS HHS [290-97-0001] NR 41 TC 107 Z9 110 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1079-6061 J9 J TRAUMA JI J. Trauma-Injury Infect. Crit. Care PD JUL PY 2000 VL 49 IS 1 BP 132 EP 138 DI 10.1097/00005373-200007000-00020 PG 7 WC Critical Care Medicine; Surgery SC General & Internal Medicine; Surgery GA 335LH UT WOS:000088244600029 PM 10912869 ER PT J AU Velmahos, GC Kern, J Chan, LS Oder, D Murray, JA Shekelle, P AF Velmahos, GC Kern, J Chan, LS Oder, D Murray, JA Shekelle, P TI Prevention of venous thromboembolism after injury: An evidence-based report - Part II: Analysis of risk factors and evaluation of the role of vena caval filters SO JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE LA English DT Article DE trauma; injury; venous thromboembolism; deep venous thrombosis; pulmonary embolism; risk factors; spinal injury; spinal cord injury; vena cava filters; vena cava interruption ID DEEP-VEIN THROMBOSIS; MOLECULAR-WEIGHT HEPARIN; MULTIPLE TRAUMA PATIENTS; PULMONARY-EMBOLISM; MAJOR TRAUMA; PROPHYLAXIS; EFFICACY; PLACEMENT; INSERTION AB Objective: In part II, we describe the results of the literature search and data analysis concerning risk factors for venous thromboembolism and the role of vena caval filters (VCF) in preventing pulmonary embolism. Methods: The methodology used in part I was used in part II. Results: Spinal fractures and spinal-cord injuries increase the risk for development of deep venous thrombosis (DVT) by twofold and threefold, respectively. Patients with DVT were an average of 9 years older than patients without DVT, No specific age cut-off point for increased risk could be established because data could not be combined across studies. Patients with prophylactically, inserted VCF bad a lower incidence of pulmonary embolism (0.2%) compared with concurrently managed patients without VCF (1.5%) or historical controls without VCF (5.8%). These results are reported on uncontrolled studies with observational design. Conclusion: spinal injuries, spinal cord injuries, and age are risk factors for development of DVT. Prophylactic placement of VCF in selected trauma patients may decrease the incidence of pulmonary embolism. Future research with well-designed studies is required to provide definitive answers. C1 Univ So Calif, Los Angeles Cty Med Ctr, Div Res & Biostat, Los Angeles, CA 90033 USA. Univ So Calif, Dept Surg, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Dept Clin Pharmacol, Los Angeles, CA 90033 USA. Univ So Calif, Sch Pharm, Los Angeles, CA 90033 USA. Greater Los Angeles VA Hlth Care Syst, Santa Monica, CA USA. RAND Corp, Santa Monica, CA USA. RP Velmahos, GC (reprint author), Univ So Calif, Los Angeles Cty Med Ctr, Div Res & Biostat, 1200 N State St,Room 9900, Los Angeles, CA 90033 USA. FU PHS HHS [290-97-0001] NR 34 TC 74 Z9 77 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1079-6061 J9 J TRAUMA JI J. Trauma-Injury Infect. Crit. Care PD JUL PY 2000 VL 49 IS 1 BP 140 EP 144 DI 10.1097/00005373-200007000-00021 PG 5 WC Critical Care Medicine; Surgery SC General & Internal Medicine; Surgery GA 335LH UT WOS:000088244600031 PM 10912870 ER PT J AU de Virgilio, C Toosie, K Ephraim, L Elbassir, M Donayre, C Baker, JD Narahara, K Mishkin, F Lewis, RJ Chang, C White, R Mody, FV AF de Virgilio, C Toosie, K Ephraim, L Elbassir, M Donayre, C Baker, JD Narahara, K Mishkin, F Lewis, RJ Chang, C White, R Mody, FV TI Dipyridamole-thallium/sestamibi before vascular surgery: A prospective blinded study in moderate-risk patients SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 14th Annual Meeting of the Western-Vascular-Society CY SEP 19-22, 1999 CL CALIFORNIA SP Western Vascular Soc ID ABDOMINAL AORTIC-SURGERY; CORONARY-ARTERY DISEASE; EMISSION COMPUTED-TOMOGRAPHY; CARDIAC RISK; MYOCARDIAL-INFARCTION; 2-METHOXYISOBUTYL ISONITRILE; THALLIUM SCANS; SCINTIGRAPHY; ANGIOGRAPHY; MORBIDITY AB Purpose: This study assessed in a prospective, blinded fashion whether a reversible defect on dipyridamole-thallium (DTHAL)/sestamibi (DMIBI) can predict adverse cardiac events after elective vascular surgery in patients with one or more clinical risk factors. Methods: Consecutive patients with one or more clinical risk factors underwent a preoperative blinded DTHAL/DMIBI. Patients with recent congestive heart failure (CHP) or myocardial infarction (MI) or severe or unstable angina were excluded. Results: Eighty patients (78% men; mean age, 65 years) completed the study. Diabetes mellitus was the most frequent clinical risk factor (73%), followed by age older than 70 years (41%), angina (29%), Q wave on electrocardiogram (26%), history of CHP (7%), and ventricular ectopy (3%). The results of DTHAL/DMIBI were normal in 36 patients (45%); a reversible plus or minus fixed defect was demonstrated in 28 patients (36%), and a fixed defect alone was demonstrated in 15 patients (19%). Nine adverse cardiac events (11%) occurred, including three cases of CHF, and one case each of unstable angina, Q wave MI, non-Q wave MI, and cardiac arrest (successfully resuscitated). Two cardiac deaths occurred (2% overall mortality), one after a Q wave MI and one after CHF and a non-Q wave MI. The cardiac event rate was 14% for reversible defect and 9.8% without reversible defect (P = .71). The cardiac event rate was 12.5% (one of eight cases) for two or more reversible defects, versus 11.1% (eight of 72 cases) for fewer than two reversible defects (P = 1.0). The sensitivity rate of two or more areas of redistribution was 11% (95% CI, 0.3%-48%), the specificity rate was 90%, and the positive and negative predictive values were 12.5% and 89%, respectively. Conclusion: Our study demonstrated no association between reversible defects on DTHAL/DMIBI and adverse cardiac events in moderate-risk patients undergoing elective vascular surgery. C1 Harbor UCLA Med Ctr, Div Vasc Surg, Dept Surg, Torrance, CA 90509 USA. W Los Angeles VA Med Ctr, Dept Surg, Div Vasc Surg, Torrance, CA USA. Harbor UCLA Med Ctr, Dept Med, Div Cardiol, Torrance, CA 90509 USA. W Los Angeles VA Med Ctr, Dept Med, Div Cardiol, Torrance, CA USA. Harbor UCLA Med Ctr, Dept Emergency Med, Torrance, CA 90509 USA. Harbor UCLA Med Ctr, Dept Radiol, Div Nucl Med, Torrance, CA 90509 USA. RP de Virgilio, C (reprint author), Harbor UCLA Med Ctr, Div Vasc Surg, Dept Surg, 1000 W Carson St, Torrance, CA 90509 USA. NR 24 TC 13 Z9 14 U1 0 U2 0 PU MOSBY, INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD JUL PY 2000 VL 32 IS 1 BP 77 EP 86 DI 10.1067/mva.2000.107311 PG 10 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 334ED UT WOS:000088172500017 PM 10876209 ER PT J AU Grovit-Ferbas, K Hsu, JF Ferbas, J Gudeman, V Chen, ISY AF Grovit-Ferbas, K Hsu, JF Ferbas, J Gudeman, V Chen, ISY TI Enhanced binding of antibodies to neutralization epitopes following thermal and chemical inactivation of human immunodeficiency virus type 1 SO JOURNAL OF VIROLOGY LA English DT Article ID T-LYMPHOCYTE RESPONSES; ENVELOPE GLYCOPROTEIN; LYMPHOTROPIC VIRUS; GP120 GLYCOPROTEIN; SIV VACCINE; SOLUBLE CD4; HIV; INFECTION; VIRIONS; CELLS AB Inactivation of viral particles is the basis for several vaccines currently in use. Initial attempts to use simian immunodeficiency virus to model a killed human immunodeficiency virus type 1 (HIV-1) vaccine were unsuccessful, and limited subsequent effort has been directed toward a systematic study of the requirements For a protective killed HIV-1 vaccine. Recent insights into BTV-l virion and glycoprotein structure and neutralization epitopes led us to revisit whether inactivated HIV-1 particles could serve as the basis for an HIV-I vaccine. Our results indicate that relatively simple processes involving thermal and chemical inactivation can inactivate HIV-1 by at least 7 logs. For some HIV-I strains, significant amounts of envelope glycoproteins are retained in high-molecular-weight fractions. Importantly, we demonstrate retention of each of three conformation-dependent neutralization epitopes, Moreover, reactivity of monoclonal antibodies directed toward these epitopes is increased following treatment, suggesting greater exposure of the epitopes, In contrast, treatment of free envelope under the same conditions leads only to decreased antibody recognition. These inactivated virions can also be presented by human dendritic cells to direct a cell-mediated immune response in vitro. These data indicate that a systematic study of HIV-1 inactivation, gp120 retention, and epitope reactivity with conformation-specific neutralizing antibodies can provide important insights for the development of an effective killed HIV-1 vaccine. C1 Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Microbiol & Immunol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Med, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, AIDS Inst, Los Angeles, CA 90095 USA. RP Chen, ISY (reprint author), Univ Calif Los Angeles, Sch Med, Dept Med, 11-934 Factor Bldg, Los Angeles, CA 90095 USA. FU NIAID NIH HHS [R15 AI082515, AI/MH28697, R21-AI42687, N0I-AI-82515] NR 47 TC 21 Z9 22 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD JUL PY 2000 VL 74 IS 13 BP 5802 EP 5809 DI 10.1128/JVI.74.13.5802-5809.2000 PG 8 WC Virology SC Virology GA 322GH UT WOS:000087501500008 PM 10846059 ER PT J AU Cefalu, WT Terry, JG Thomas, MJ Morgan, TM Edwards, IJ Rudel, LL Kemnitz, JW Weindruch, R AF Cefalu, WT Terry, JG Thomas, MJ Morgan, TM Edwards, IJ Rudel, LL Kemnitz, JW Weindruch, R TI In vitro oxidation of low-density lipoprotein in two species of nonhuman primates subjected to caloric restriction SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID CORONARY-ARTERY ATHEROSCLEROSIS; AFRICAN-GREEN MONKEYS; RHESUS-MONKEYS; DIETARY RESTRICTION; PROTEIN OXIDATION; FATTY-ACIDS; ALPHA-TOCOPHEROL; SUSCEPTIBILITY; CHOLESTEROL; PLASMA AB Caloric restriction (CR), which increases longevity and retards age-associated diseases in laboratory rodents, is being evaluated in nonhuman primate trials. CR reduces oxidative stress in rodents and appears to improve risk factors for cardiovascular disease in nonhuman primates. We tested the hypothesis that low-density lipoprotein (LDL) oxidizability is reduced in two monkey species (rhesus and cynomolgus) subjected to chronic CR. In both species, no significant differences occurred between CR and control animals on total, LDL, or high-density lipoprotein (HDL) cholesterol. In rhesus monkeys, triglycerides were higher in controls than CR (139 +/- 23 vs 66 +/- 8 mg/dl, p < .01, respectively). LDL from CR rhesus monkeys was reduced in triglyceride content and molecular weight compared to controls, whereas LDL composition in cynomolgus monkeys was similar in CR and control animals. In keeping with minor deviations in lipids, antioxidants, and LDL composition, no consistent differences in in vitro LDL oxidizability were apparent between CR and controls in either species. C1 Univ Vermont, Coll Med, Endocrine Unit, Dept Med, Burlington, VT 05405 USA. Wake Forest Univ, Sch Med, Dept Med Comparat Med & Publ Hlth Sci, Winston Salem, NC 27109 USA. Wisconsin Reg Primate Ctr, Madison, WI USA. Univ Wisconsin, Dept Med, Madison, WI USA. William S Middleton Mem Vet Adm Med Ctr, GRECC, Madison, WI 53705 USA. RP Cefalu, WT (reprint author), Univ Vermont, Coll Med, Endocrine Unit, Dept Med, Given C331, Burlington, VT 05405 USA. FU NIA NIH HHS [P01AG11915, R29AG10816, K01AG00578] NR 35 TC 9 Z9 9 U1 0 U2 0 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD JUL PY 2000 VL 55 IS 7 BP B355 EP B361 PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 331XW UT WOS:000088044800005 PM 10898249 ER PT J AU Pine, ZM Gurland, B Chren, MM AF Pine, ZM Gurland, B Chren, MM TI Report of having slowed down: Evidence for the validity of a new way to inquire about mild disability in elders SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID SELF-RATED HEALTH; OLDER ADULTS; GERIATRIC ASSESSMENT; COMMUNITY; OUTCOMES; PEOPLE; LIFE AB Background. Mild disability in elderly persons may be detected by eliciting reports of modified task performance. even in the absence of reported difficulty. This study provides evidence for the validity of one type of task modification, namely, slowing, as a measure of mild walking disability. Methods. Community-dwelling elders (N = 287) were questioned about whether they were walking indoors as quickly as they had 1 year before and 10 years before. Construct validity was assessed by the degree to which responses to these two questions were logically consistent with a general decline in walking speed, and by determining whether reported slowing was associated with concurrent reports of difficulty walking and with measured gait speed. Predictive validity in subjects without reported difficulty walking was gauged by the association of reported slowing sith adverse walking outcomes at I-year follow-up. Results. Reports of slowing over 10- and 1-year periods were almost uniformly consistent with a general decline in speed. Reported slowing was significantly associated with reported difficulty walking and with slower gait speed. In the subgroup of riders initially reporting no difficulty walking, reported slowing significantly predicted incident difficulty walking at follow-up, as well as other adverse walking outcomes. For example, among elders who reported slowing, 7%. 10%, and 19% developed new difficulty walking indoors, new difficulty walking outdoors, or stopped walking for pleasure, compared with 0%, 0%, and 3% for those who had not reported slowing (p < .05). Conclusions. This study provides evidence for the construct and predictive validity of one type of task modification, namely, slowing in indoor walking. This work contributes to the development of new methods for measuring mild disability, which may in turn form the basis for clinical interventions based on the early identification of functional problems. C1 Univ Calif San Francisco, Mt Zion Ctr Aging, Div Geriatr, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Ctr Excellence Acad Geriatr, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Dermatol, San Francisco, CA 94143 USA. Columbia Univ, Stroud Ctr, New York, NY USA. San Francisco Vet Affairs Med Ctr, San Francisco, CA USA. RP Pine, ZM (reprint author), VA Med Ctr, Div Geriatr, Box 111G,4150 Clement St, San Francisco, CA 94121 USA. FU NCRR NIH HHS [RR00645]; NIA NIH HHS [P01 AG07232, R01 AG10489] NR 21 TC 9 Z9 9 U1 1 U2 2 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD JUL PY 2000 VL 55 IS 7 BP M378 EP M383 PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 331XW UT WOS:000088044800010 PM 10898254 ER PT J AU Alem, AM Sherrard, DJ Gillen, DL Weiss, NS Beresford, SA Heckbert, SR Wong, C Stehman-Breen, C AF Alem, AM Sherrard, DJ Gillen, DL Weiss, NS Beresford, SA Heckbert, SR Wong, C Stehman-Breen, C TI Increased risk of hip fracture among patients with end-stage renal disease SO KIDNEY INTERNATIONAL LA English DT Article DE bone fracture and dialysis; dialysis; osteopenia; age and hip fracture; CAPD; peritoneal dialysis ID OSTEOPOROTIC FRACTURES; ELDERLY MEN; WOMEN; BONE; OSTEODYSTROPHY; EPIDEMIOLOGY; POPULATION; PREVALENCE; MORTALITY; THERAPY AB Background. Although patients with end-stage renal disease (ESRD) are at increased risk for bone loss, the risk of hip fracture in this population is not known. We compared the risk of hip Fracture among dialysis patients with the general population. Methods. We used data from the United States Renal Data System (USRDS) to identify all new Caucasian dialysis patients who began dialysis between January 1, 1989, and December 31, 1996. All hip fractures occurring during this time period were ascertained. The observed number of hip fractures was compared with the expected number based on the experience of residents of Olmstead County (MN, USA). Standardized incidence ratios were calculated as the ratio between observed and expected. The risk attributable to ESRD was calculated as the difference between the observed and expected rate of hip fracture per 1000 person-years. Results. The number of dialysis patients was 326,463 (55.9% male and 44.1% female). There were 6532 hip fractures observed during the follow-up period of 643,831 patient years. The overall incidence of hip fracture was 7.35 per 1000 person years for males and 13.63 per 1000 person years for females. The overall relative risk for hip fracture was 4.44 (95% CI, 4.16 to 3.75) for male dialysis patients and 4.40 (95% CI, 3.17 to 4.64) for female dialysis patients compared with people of the same sex in the general population. While the age-specific relative risk of hip fracture was highest in the youngest age groups, the added risks of fracture associated with dialysis rose steadily with increasing age. The relative risk of hip fracture increased as time since first dialysis increased. Conclusions. The overall risk of hip fracture among Caucasian patients with ESRD is considerably higher than in the general population, independent of age and gender. C1 VA Puget Sound Hlth Care Syst, Div Nephrol, Seattle, WA 98108 USA. Univ Washington, Div Nephrol, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth & Community Med, Seattle, WA 98195 USA. RP Stehman-Breen, C (reprint author), VA Puget Sound Hlth Care Syst, Div Nephrol, 1660 S Columbian Way,Mailstop 111A, Seattle, WA 98108 USA. NR 27 TC 346 Z9 355 U1 0 U2 10 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD JUL PY 2000 VL 58 IS 1 BP 396 EP 399 DI 10.1046/j.1523-1755.2000.00178.x PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 328VE UT WOS:000087870100044 PM 10886587 ER PT J AU Armstrong, K Popik, S Guerra, C Ubel, PA AF Armstrong, K Popik, S Guerra, C Ubel, PA TI Beliefs about breast cancer risk and use of postmenopausal hormone replacement therapy SO MEDICAL DECISION MAKING LA English DT Article DE postmenopausal hormone replacement therapy; breast cancer risk perception ID WOMENS KNOWLEDGE; AFRICAN-AMERICAN; ATTITUDES; OSTEOPOROSIS; PERCEPTIONS; PREVENTION; ESTROGENS; MORTALITY; BENEFIT; AGE AB Background. Postmenopausal hormone replacement therapy (HRT) decreases the risks of coronary heart disease and osteoporosis, but increases the risk of breast cancer. Although only 20-30% of postmenopausal women in the United States take HRT, the relationship between breast cancer risk perception and use of HRT is not known. Objective. To assess the impact of belief that HRT increases breast cancer risk and high perceived risk of breast cancer on the use of HRT. Design. Cross-sectional mailed survey. Participants. 189 randomly selected postmenopausal women from a general internal medicine practice in the Philadelphia area. Main results. Of the 268 women (67%) who returned surveys, 189 were postmenopausal; 70 (37%) were currently using HRT and 21 (11%) had previously used HRT. Respondents' mean age was 59.6 years: 64% were Caucasian, and 33% had completed college. Fifty-nine women (33%) thought HRT increased the risk of breast cancer, 22 (12%) thought it did not, and 100 (55%) were unsure. Mean perceived lifetime risk of breast cancer was 31% (range 0%-100%). After multivariate adjustment, current use of HRT was inversely associated with age (OR 0.96 for each one-year increase, 95% CI 0.94-0.98), and positively associated with Caucasian race (OR 2.73, 95% CI 1.40-5.32). Use of HRT was not associated with belief that HRT increases the risk of breast cancer, breast cancer risk perception, or perceived severity of breast cancer. Conclusions. Belief that HRT increases the risk of breast cancer and high perceptions of breast cancer risk may not be important barriers to use of HRT. Efforts to improve decision making about HRT should focus on previously established barriers, such as perceptions of menopause and lack of physician discussion. rather than misconceptions about breast cancer risk. C1 Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Canc, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Armstrong, K (reprint author), 1233 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. NR 27 TC 14 Z9 14 U1 0 U2 1 PU HANLEY & BELFUS INC PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 USA SN 0272-989X J9 MED DECIS MAKING JI Med. Decis. Mak. PD JUL-SEP PY 2000 VL 20 IS 3 BP 308 EP 313 DI 10.1177/0272989X0002000307 PG 6 WC Health Care Sciences & Services; Medical Informatics SC Health Care Sciences & Services; Medical Informatics GA 333UM UT WOS:000088149200007 PM 10929853 ER PT J AU Gerard, HC Schumacher, HR El-Gabalawy, H Goldbach-Mansky, R Hudson, AP AF Gerard, HC Schumacher, HR El-Gabalawy, H Goldbach-Mansky, R Hudson, AP TI Chlamydia pneumoniae present in the human synovium are viable and metabolically active SO MICROBIAL PATHOGENESIS LA English DT Article DE C. pneumoniae; reactive arthritis; bacterial pathogenesis; synovium ID REACTIVE ARTHRITIS; STRAIN TWAR; TRACHOMATIS DNA; GENE; IDENTIFICATION; INFECTION; TISSUE; FLUID AB We demonstrated that chromosomal DNA from Chlamydia pneumoniae is present in synovial tissue in at least some patients with reactive arthritis/Reiter's syndrome and other arthritides. Here, we provide initial molecular evidence that the bacterium is viable and metabolically active when present in the synovium. We used reverse transcription-polymerase chain reaction (RT-PCR) assays targeting primary transcripts from the chlamydial rRNA operons, and mRNA from several C, pneumoniae genes (hsp60, ompA, KDO transferase, Mr=76000 protein), to analyse RNA preparations from synovial tissue of 10 patients with various forms of arthritis; each patient was known to be PCR-positive for C. pneumoniae DNA in synovium prior to RT-PCR assays. Two PCR-negative patients served as controls for RT-PCR assays. in the in patients PCR-positive for C. pneumoniae DNA, RT-PCR assays targeting primary transcripts from the rRNA operons of the organism showed that these molecules were present in each sample, as were transcripts from the bacterial hsp60 gene. Assays targeting mRNAs from the Mr=76000 protein and the KDO transferase genes of C. pneumoniae gave positive results for 6/10 preparations. We were unable to identify mRNA from the chlamydial major outer membrane protein gene (ompA) in any preparation. RNA preparations from the two control patients were negative in all RT-PCR assays targeting C. pneumoniae transcripts. These results indicate that in patients infected with the organism, synovial C. pneumoniae are viable and metabolically active, as are C. trachomatis cells in the same context. Such viability is consistent with a role in long-term contribution to pathogenesis in joint disease. (C) 2000 Academic Press. C1 Wayne State Univ, Sch Med, Dept Immunol & Microbiol, Detroit, MI 48201 USA. Univ Penn, Sch Med, Dept Med, Div Rheumatol, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Med Res Serv, Philadelphia, PA 19104 USA. NIAMS, Arthrit & Rheumatism Branch, NIH, Bethesda, MD USA. RP Hudson, AP (reprint author), Wayne State Univ, Sch Med, Dept Immunol & Microbiol, Gordon H Scott Hall,540 E Canfield Ave, Detroit, MI 48201 USA. FU NIAMS NIH HHS [AR42541] NR 24 TC 48 Z9 49 U1 0 U2 0 PU ACADEMIC PRESS LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0882-4010 J9 MICROB PATHOGENESIS JI Microb. Pathog. PD JUL PY 2000 VL 29 IS 1 BP 17 EP 24 DI 10.1006/mpat.2000.0360 PG 8 WC Immunology; Microbiology SC Immunology; Microbiology GA 333LX UT WOS:000088132500003 PM 10873487 ER PT J AU Haake, DA AF Haake, DA TI Spirochaetal lipoproteins and pathogenesis SO MICROBIOLOGY-UK LA English DT Review DE lipoprotein; bacterial outer membrane; pathogenesis ID OUTER SURFACE-PROTEIN; BORRELIA-BURGDORFERI LIPOPROTEINS; VIRULENT TREPONEMA-PALLIDUM; LYME-DISEASE SPIROCHETE; DECORIN-BINDING-PROTEIN; INTEGRAL MEMBRANE-PROTEINS; TOLL-LIKE RECEPTOR-2; MOLECULAR-CLONING; GLYCEROPHOSPHODIESTER PHOSPHODIESTERASE; SYPHILIS SPIROCHETE C1 Vet Affairs Greater Los Angeles Hlth Care Syst, Div Infect Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90095 USA. RP Haake, DA (reprint author), Vet Affairs Greater Los Angeles Hlth Care Syst, Div Infect Dis, 111F, Los Angeles, CA 90073 USA. FU NIAID NIH HHS [R29 AI034431, AI34431, R01 AI034431, R21 AI034431, R29 AI034431-05] NR 110 TC 123 Z9 135 U1 0 U2 5 PU SOC GENERAL MICROBIOLOGY PI READING PA MARLBOROUGH HOUSE, BASINGSTOKE RD, SPENCERS WOODS, READING RG7 1AE, BERKS, ENGLAND SN 1350-0872 J9 MICROBIOL-UK JI Microbiology-(UK) PD JUL PY 2000 VL 146 BP 1491 EP 1504 PN 7 PG 14 WC Microbiology SC Microbiology GA 334ER UT WOS:000088174000001 PM 10878114 ER PT J AU Allen, DN Goldstein, G Forman, SD Keshavan, MS van Kammen, DP Sanders, RD AF Allen, DN Goldstein, G Forman, SD Keshavan, MS van Kammen, DP Sanders, RD TI Neurologic examination abnormalities in schizophrenia with and without a history of alcoholism SO NEUROPSYCHIATRY NEUROPSYCHOLOGY AND BEHAVIORAL NEUROLOGY LA English DT Article ID SOFT SIGNS; SUBSTANCE-ABUSE; NEUROCOGNITIVE FUNCTION; DYSFUNCTION; PREVALENCE; DISORDERS AB Objective: The current investigation examines the impact of a past history of alcoholism on neurologic examination abnormalities in schizophrenia (SZ). Background: Individuals with SZ have a high rate of comorbid alcohol use disorders (AUDs), but relatively little is known about the potential adverse consequences of alcoholism for neuropsychological and neurologic functioning in SZ. Recent evidence suggests consistent but subtle neurocognitive differences between groups, with more prominent differences in neurologic examination abnormalities. Method: Thirty-three male patients with SZ or SZ/AUDs were evaluated using a modified Neurologic Evaluation Scale (NES) and ratings for positive and negative symptoms. Results: The SZ/AUD group exhibited a greater impairment in the Cognitive-Perceptual factor of the Neurologic Evaluation Scale. Greater impairment in the tandem-Romberg factor or in motor items was not found, nor were groups different based on positive or negative symptoms. Conclusions: A history of alcoholism in SZ is associated with greater overall neurologic impairment, particularly in the area of cognitive-perceptual dysfunction, an area often found to be impaired in patients with schizophrenia without alcoholism. C1 Univ Nevada, Dept Psychol, Las Vegas, NV 89154 USA. Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA USA. Robert Wood Johnson Pharmaceut Res Inst, Raritan, NJ USA. RP Sanders, RD (reprint author), 116 A-H,7180 Highland Dr, Pittsburgh, PA 15206 USA. FU NIMH NIH HHS [MH-44841] NR 30 TC 21 Z9 21 U1 2 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0894-878X J9 NEUROPSY NEUROPSY BE JI Neuropsychiatr. Neuropsychol. Behav. Neurol. PD JUL PY 2000 VL 13 IS 3 BP 184 EP 187 PG 4 WC Clinical Neurology; Psychiatry; Psychology SC Neurosciences & Neurology; Psychiatry; Psychology GA 332PH UT WOS:000088082300006 PM 10910089 ER PT J AU Jacobson, AF AF Jacobson, AF TI Association of prostate-specific antigen levels and patterns of benign and malignant uptake detected on bone scintigraphy in patients with newly diagnosed prostate carcinoma SO NUCLEAR MEDICINE COMMUNICATIONS LA English DT Article ID NO KNOWN METASTASES; CANCER-PATIENTS; SCAN; PHOSPHATASE; ABNORMALITIES AB The bone scan patterns of benign and malignant uptake in 432 patients with newly diagnosed prostate carcinoma were reviewed in relation to prostate-specific antigen (PSA) levels determined within 4 months of scintigraphy. Scan results were categorized in terms of likelihood of metastatic disease and anatomical locations of benign and malignant lesions were tabulated. At least one suspect focus was identified in 138 scans (32%), and metastatic bone disease was present in 38 (9%). Metastatic disease prevalence increased from 1% for PSA <20 ng.ml(-1) to 58% for PSA>100 ng.ml(-1). Among patients with PSA>20 ng.ml(-1) (n = 157), 70 (45%) had at least one bone scan finding of concern for metastases and 35 (22%) proved to have metastatic disease. Almost all scans with metastases had either limited disease (less than or equal to 5 suspicious lesions; n = 16; 42%) or extensive metastases (>20 abnormalities; n = 19; 50%). The majority of patients with Limited skeletal metastases had PSA < 100 ng.ml(-1) (11/16; 69%), while almost all patients with extensive skeletal involvement had PSA,100 ng.ml(-1) (17/19; 89%). Among those with Limited metastatic disease, most (13/16; 81%) had at least one lesion in the pelvis or sacrum; the next most common sites were in the thoracic and lumbar spine (six each; 38%). in scans with a low to moderate suspicion for bone metastases, the only anatomical site with a significantly higher prevalence of malignant than benign lesions was the pelvis. ((C) 2000 Lippincott Williams & Wilkins). C1 VA Puget Sound Hlth Care Syst, Seattle Div, Nucl Med Sect 115, Seattle, WA 98108 USA. RP Jacobson, AF (reprint author), VA Puget Sound Hlth Care Syst, Seattle Div, Nucl Med Sect 115, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 25 TC 7 Z9 8 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0143-3636 J9 NUCL MED COMMUN JI Nucl. Med. Commun. PD JUL PY 2000 VL 21 IS 7 BP 617 EP 622 DI 10.1097/00006231-200007000-00003 PG 6 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 341AE UT WOS:000088568200003 PM 10994663 ER PT J AU Hickey, RW Kochanek, PM Ferimer, H Graham, SH Safar, P AF Hickey, RW Kochanek, PM Ferimer, H Graham, SH Safar, P TI Hypothermia and hyperthermia in children after resuscitation from cardiac arrest SO PEDIATRICS LA English DT Article DE cardiac arrest; temperature; fever; hypothermia ID CARDIOPULMONARY-RESUSCITATION; CEREBRAL-ISCHEMIA; NEURONAL DAMAGE; BRAIN; TEMPERATURE; STROKE AB Objective. In experimental models of ischemic-anoxic brain injury, changes in body temperature after the insult have a profound influence on neurologic outcome. Specifically, hypothermia ameliorates whereas hyperthermia exacerbates neurologic injury. Accordingly, we sought to determine the temperature changes occurring in children after resuscitation from cardiac arrest. Study Design. The clinical records of 13 children resuscitated from cardiac arrest were analyzed. Patients were identified through the emergency department and pediatric intensive care unit arrest logs. Only patients surviving for greater than or equal to 12 hours after resuscitation were considered for analysis. Charts were reviewed for body temperatures, warming or cooling interventions, antipyretic and antimicrobial administration, and evidence of infection. Results. Seven patients had a minimum temperature (T min) of less than or equal to 35 degrees C and 11 had a maximum temperature (T max) of greater than or equal to 38.1 degrees C. Hypothermia often preceded hyperthermia. All 7 patients with T min less than or equal to 35 degrees C were actively warmed with heating lamps and 5 of 7 responded to warming with a rebound of body temperatures greater than or equal to 38.1 degrees C. None of the 6 patients with T min >35 degrees C were actively warmed but all developed T max greater than or equal to 38.1 degrees C. Six patients received antipyretics and 11 received antibiotics. Fever was not associated with a positive culture in any case. Conclusion. Spontaneous hypothermia followed by hyperthermia is common after resuscitation from cardiac arrest. Temperature should be closely monitored after cardiac arrest and fever should be managed expectantly. C1 Childrens Hosp Pittsburgh, Dept Pediat, Div Pediat Emergency Med, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Anesthesia Crit Care Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Pittsburgh, PA 15260 USA. Mercy Hosp, Dept Pediat, Pittsburgh, PA 15219 USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15260 USA. VA Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Hickey, RW (reprint author), Childrens Hosp Pittsburgh, Dept Pediat, Div Pediat Emergency Med, 3705 5th Ave, Pittsburgh, PA 15213 USA. RI Kochanek, Patrick/D-2371-2015 OI Kochanek, Patrick/0000-0002-2627-913X NR 21 TC 59 Z9 60 U1 0 U2 0 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD JUL PY 2000 VL 106 IS 1 BP 118 EP 122 DI 10.1542/peds.106.1.118 PG 5 WC Pediatrics SC Pediatrics GA 330YZ UT WOS:000087990400035 PM 10878160 ER PT J AU Jarvik, ME Madsen, DC Olmstead, RE Iwamoto-Schaap, PN Elins, JL Benowitz, NL AF Jarvik, ME Madsen, DC Olmstead, RE Iwamoto-Schaap, PN Elins, JL Benowitz, NL TI Nicotine blood levels and subjective craving for cigarettes SO PHARMACOLOGY BIOCHEMISTRY AND BEHAVIOR LA English DT Article DE nicotine; craving; withdrawal; cigarette; abstinence ID SMOKING CESSATION; WITHDRAWAL SYMPTOMS; TOBACCO WITHDRAWAL; QUESTIONNAIRE; DOPAMINE; RELEASE AB This study examined cigarette craving and blood nicotine levels in 11 male heavy smokers who were observed during 16 h of tobacco abstinence. Subjects rated their urge to smoke on a new brief 10-item questionnaire, Urge to Smoke (UTS), Schuh and Stitzer's four-item Visual Analog Scale (SSI), and a Strength of Urge to Smoke (SUTS) item. Testing occurred: 1) after 16 h (1700 h the night before to 0900 h the next morning) of abstinence from smoking; 2) after an ad lib smoking period following the 16 h abstinence; 3) every hour during 6 hours of abstinence; 4) and finally, after the 6 h abstinence, another ad lib smoking period. Thus, subjects smoked twice in each session. Blood plasma nicotine levels were measured before, after, and every 2 h during the 6-h abstinence period for a total of six measures. Blood pressure and heart rate were measured prior to each blood draw. There was a significant negative correlation between blood nicotine levels and craving for cigarettes on all craving questionnaires (rs = -0.55 to -0.78; ps < 0.002). Carbon monoxide was shown to correlate highly with nicotine blood levels (rs = 0.83 to 0.98 across subjects. ps < 0.001). Results are consistent with the hypothesis that "urge to smoke" reflects nicotine seeking in continuing smokers. (C) 2000 Elsevier Science inc. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90073 USA. San Francisco Gen Hosp, Sch Med & Psychiat, San Francisco, CA 94110 USA. RP Jarvik, ME (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd,T-350,619-B151D, Los Angeles, CA 90073 USA. FU NIDA NIH HHS [DA02277] NR 23 TC 125 Z9 127 U1 2 U2 9 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0091-3057 J9 PHARMACOL BIOCHEM BE JI Pharmacol. Biochem. Behav. PD JUL PY 2000 VL 66 IS 3 BP 553 EP 558 DI 10.1016/S0091-3057(00)00261-6 PG 6 WC Behavioral Sciences; Neurosciences; Pharmacology & Pharmacy SC Behavioral Sciences; Neurosciences & Neurology; Pharmacology & Pharmacy GA 337HN UT WOS:000088351500013 PM 10899369 ER PT J AU O'Neill, J Halgren, E Marinkovic, K Siembieda, D Refai, D Fitten, LJ Perryman, K Fisher, A AF O'Neill, J Halgren, E Marinkovic, K Siembieda, D Refai, D Fitten, LJ Perryman, K Fisher, A TI Effects of muscarinic and adrenergic agonism on auditory P300 in the macaque SO PHYSIOLOGY & BEHAVIOR LA English DT Article DE primates; evoked potentials; P300; muscarinic agonist; noradrenergic agonist; AF102B; guanfacine ID EVENT-RELATED POTENTIALS; ALZHEIMER-TYPE DEMENTIA; LONG-LATENCY; P300-LIKE POTENTIALS; ODDBALL PARADIGM; SQUIRREL-MONKEYS; BEHAVING MONKEY; AGED MONKEYS; SYSTEM; CLONIDINE AB Homologs of human endogenous evoked potentials are known in several species of nonhuman primates, but the neurotransmitter substrates of these potentials remain uncertain. In particular, the role of central cholinergic and adrenergic systems is not yet clearly defined. We recorded cognitive evoked potentials from the scalp in four adult bonnet macaque monkeys during a passive version of the auditory oddball paradigm with unique novel stimuli under saline control conditions. In two subjects each, cognitive evoked potentials were also recorded following intramuscular administration of the mi muscarinic agonist AF102B or of the alpha-2A noradrenergic agonist guanfacine. On saline, large positivities resembling the human P300 were recorded over midline sites in response to rare or novel auditory stimuli in all four monkeys. The amplitude of these positivities was sensitive to the delivery of fruit-juice reward in association with rare stimuli in three monkeys tested. At cognition-enhancing doses, AF102B enlarged the amplitude of P300-like positivities in both monkeys tested; guanfacine enlarged the amplitude of P300-like positivities in one of two monkeys tested. These results add to existing evidence of human-like endogenous late positivities in monkeys that are influenced by the cholinergic and adrenergic systems, and suggest a possible role of mi muscarinic and alpha-2A noradrenergic receptor subtypes. (C) 2000 Elsevier Science Inc. All rights reserved. C1 Dept Vet Affairs W LA Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90024 USA. Univ Utah, Dept Radiol, Salt Lake City, UT 84108 USA. Dept Vet Affairs Sepulveda Med Ctr, N Hills, CA 91343 USA. Eilan Inst Biol Res, IL-74100 Ness Ziona, Israel. RP O'Neill, J (reprint author), San Francisco VAMC, MRI Unit, 114M,4150 Clement St, San Francisco, CA 94121 USA. NR 47 TC 12 Z9 12 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0031-9384 J9 PHYSIOL BEHAV JI Physiol. Behav. PD JUL 1 PY 2000 VL 70 IS 1-2 BP 163 EP 170 DI 10.1016/S0031-9384(00)00258-4 PG 8 WC Psychology, Biological; Behavioral Sciences SC Psychology; Behavioral Sciences GA 356DM UT WOS:000089429100023 PM 10978492 ER PT J AU Tyan, ML AF Tyan, ML TI Effects of inositol, LiCl, and heparin on the antibody responses to SRBC by normal and immunodeficient XID mice SO PROCEEDINGS OF THE SOCIETY FOR EXPERIMENTAL BIOLOGY AND MEDICINE LA English DT Article ID BRUTONS TYROSINE KINASE; TRISPHOSPHATE; RECEPTOR; CELLS; MYOINOSITOL; PATHWAYS; RELEASE; CA2+ AB Spleen cells from naive adult immunocompetent and immunodeficient XID mice were cultured on agar containing sheep red blood cells (SRBC) with and without myo-inositol, scyllo-inositol, lithium chloride, or heparin, and after 1 or 2 days the number of colonies of antiSRBC antibody-forming cells (PFC) were determined. It was found that myo-inositol and scyllo-inositol at one-tenth the concentration were equally effective in increasing the number of specific PFC, Myo-inositol, scyllo-inositol, and lithium chloride accelerated the appearance of direct foci in cultures of spleen cells from normal and XID mice, When heparin was added to cultures of XID spleen cells, PFC were found to be increased on Day 1; however, PFC and foci were not increased in cultures of spleen cells from competent mice until 1 day later, The addition of combinations of these agents to cultures of spleen cells had no positive or negative effect on the generation of fool or PFC, Normal mice given heparin intraperitoneally with SRBC had increased splenic PFC on Days 3 and 4 but not on Day 7, The results suggest that these agents modulate B-cell responses by increasing the rate of proliferation and/or secretion through a signaling pathway(s) distal to, or more likely, independent of Bruton's tyrosine Kinase (BTK), It is not clear that the mechanism is the same with each agent. C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Tyan, ML (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 18 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0037-9727 J9 P SOC EXP BIOL MED JI Proc. Soc. Exp. Biol. Med. PD JUL PY 2000 VL 224 IS 3 BP 187 EP 190 DI 10.1046/j.1525-1373.2000.22419.x PG 4 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 328RU UT WOS:000087864500010 PM 10865235 ER PT J AU Oberley, TD Zhong, WX Szweda, LI Oberley, LW AF Oberley, TD Zhong, WX Szweda, LI Oberley, LW TI Localization of antioxidant enzymes and oxidative damage products in normal and malignant prostate epithelium SO PROSTATE LA English DT Article DE prostate cancer; manganese superoxide dismutase; 4-hydroxy-2-nonenal; 8-hydroxy-2'-deoxyguanosine; nitrotyrosine ID MANGANESE SUPEROXIDE-DISMUTASE; GLUTATHIONE-S-TRANSFERASE; SYRIAN-HAMSTER TISSUES; CARCINOMA-CELLS; IMMUNOHISTOCHEMICAL LOCALIZATION; IMMUNOCHEMICAL DETECTION; IMMUNOGOLD ANALYSIS; KIDNEY DEVELOPMENT; HYDROGEN-PEROXIDE; PROTEIN ADDUCTS AB BACKGROUND. The risk for prostate cancer seems to be reduced by certain antioxidant compounds (vitamins E and A, and selenium). METHODS. Antioxidant enzymes and oxidative damage products were localized in normal prostatic epithelium and malignant glands in primary and metastatic prostatic adenocarcinomas, using well-characterized antibodies and immunoperoxidase techniques. RESULTS. Antioxidant enzymes and four markers of oxidative damage were compared in basal and secretory cells of normal prostatic epithelium and prostate adenocarcinoma cells, and each cell type had unique patterns of enzymes and oxidative damage products. One marker of oxidative damage, a fluorophore derived from 4-hydroxy-2-nonenal-lysine adduction, was found in secretory cells of normal but not malignant epithelium, demonstrating a different oxidative metabolism in normal vs. malignant prostate epithelium. Metastatic lesions from primary prostate cancer had higher levels of manganese superoxide dismutase and nuclear oxidative damage products than did primary tumors. CONCLUSIONS. Antioxidant enzymes and oxidative damage products are modulated in metastatic compared to primary prostate cancer. Prostate 44:144-155, 2000. (C) 2000 Wiley-Liss, Inc. C1 William S Middleton Mem Vet Hosp, Pathol & Lab Med Serv, Madison, WI 53705 USA. Univ Wisconsin, Sch Med, Dept Pathol & Lab Med, Madison, WI USA. Case Western Reserve Univ, Sch Med, Dept Physiol & Biophys, Cleveland, OH 44106 USA. Univ Iowa, Coll Med, Radiat Res Lab, Iowa City, IA USA. RP Oberley, TD (reprint author), William S Middleton Mem Vet Hosp, Pathol & Lab Med Serv, Room A-35,2500 Overlook Terrace, Madison, WI 53705 USA. NR 48 TC 79 Z9 79 U1 1 U2 3 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0270-4137 J9 PROSTATE JI Prostate PD JUL 1 PY 2000 VL 44 IS 2 BP 144 EP 155 DI 10.1002/1097-0045(20000701)44:2<144::AID-PROS7>3.0.CO;2-G PG 12 WC Endocrinology & Metabolism; Urology & Nephrology SC Endocrinology & Metabolism; Urology & Nephrology GA 329AY UT WOS:000087885000007 PM 10881024 ER PT J AU Fuller, TR Oka, M Otsuka, K Yokoyama, N Liberman, RP Niwa, SI AF Fuller, TR Oka, M Otsuka, K Yokoyama, N Liberman, RP Niwa, SI TI A hybrid supported employment program for persons with schizophrenia in Japan SO PSYCHIATRIC SERVICES LA English DT Article C1 Univ Calif Los Angeles, Ctr Res Treatment & Rehabil Psychosis, Los Angeles, CA 90024 USA. Fukushima Med Coll, Fukushima, Japan. RP Liberman, RP (reprint author), W Los Angeles VA Med Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 6 TC 8 Z9 9 U1 1 U2 2 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1075-2730 J9 PSYCHIATR SERV JI Psychiatr. Serv. PD JUL PY 2000 VL 51 IS 7 BP 864 EP 866 DI 10.1176/appi.ps.51.7.864 PG 3 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 331HW UT WOS:000088013800005 PM 10875948 ER PT J AU Mares, A McGuire, J AF Mares, A McGuire, J TI Reducing psychiatric hospitalization among mentally ill veterans living in board-and-care homes SO PSYCHIATRIC SERVICES LA English DT Article; Proceedings Paper CT Va Health Services Research and Development National Meeting CY FEB 24-26, 1999 CL WASHINGTON, D.C. SP VA Hlth Serv Res & Dev Natl ID CASE-MANAGEMENT; COMMUNITY; NEEDS AB Objective: The effectiveness of a community-based case management program at the Veterans Affairs West Los Angeles Healthcare Center in reducing hospital readmission of mentally ill veterans living in privately operated board-and-care homes was evaluated. Methods: A retrospective cohort design was used, The sample consisted of 321 patients identified by hospital records as living in one of 24 board-and-care homes in the Los Angeles area that were approved by the community residential care program. A total of 214 subjects who received monthly home visits from case managers (program group) were compared with 107 subjects who did not receive monthly home visits (comparison group). The median number of psychiatric bed-days used was calculated for the two years before and after follow-up. The number of days from the start of follow-up to the first psychiatric hospitalization was also calculated. Results: Among subjects in the program group, the median number of psychiatric bed-days used decreased significantly, from 59 days to 50 days. No significant change in the median number was observed for comparison subjects. Comparison subjects were rehospitalized 1.7 times more often than program subjects, Overall, program subjects under age 62 (younger subjects) were rehospitalized 2.5 times more often than older subjects. In the program group, those who had received home visits for more than two years were hospitalized three times more often than those who had received visits for less than two years, and younger subjects were rehospitalized 1.8 times more often than older subjects. Conclusions:The findings suggest that home visits conducted by case managers in a community residential care program helped reduce psychiatric hospitalization among veteran patients living in privately operated board-and-care homes. C1 Univ Calif Los Angeles, Sch Publ Policy & Social Res, Sch Social Welf, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Program Evaluat, Los Angeles, CA USA. RP Mares, A (reprint author), Univ Calif Los Angeles, Sch Publ Policy & Social Res, Sch Social Welf, 3250 Publ Policy Bldg,Box 951656, Los Angeles, CA 90095 USA. RI Mares, Alvin/I-8186-2012 NR 31 TC 8 Z9 8 U1 1 U2 4 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1075-2730 J9 PSYCHIATR SERV JI Psychiatr. Serv. PD JUL PY 2000 VL 51 IS 7 BP 914 EP 921 DI 10.1176/appi.ps.51.7.914 PG 8 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 331HW UT WOS:000088013800013 PM 10875958 ER PT J AU Caroff, SN Mann, SC Campbell, EC AF Caroff, SN Mann, SC Campbell, EC TI Risk of fatal heatstroke after hospitalization SO PSYCHIATRIC SERVICES LA English DT Letter ID HEAT C1 Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Caroff, SN (reprint author), Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. NR 5 TC 0 Z9 0 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1075-2730 J9 PSYCHIATR SERV JI Psychiatr. Serv. PD JUL PY 2000 VL 51 IS 7 BP 938 EP 938 DI 10.1176/appi.ps.51.7.938-a PG 1 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 331HW UT WOS:000088013800024 PM 10875968 ER PT J AU Kraut, JA AF Kraut, JA TI Disturbances of acid-base balance and bone disease in end-stage renal disease SO SEMINARS IN DIALYSIS LA English DT Article ID CHRONIC METABOLIC-ACIDOSIS; HIGH BICARBONATE DIALYSATE; HEMODIALYSIS-PATIENTS; PARATHYROID-HORMONE; TUBULAR-ACIDOSIS; FAILURE; CALCIUM; RAT AB Bone disease in patients with chronic renal failure (CRF) is thought to he the consequence primarily of the interplay of several factors, including the serum levels of parathyroid hormone (PTH), vitamin D, calcium, and phosphorus, and exposure to hone toxins such as aluminum or amyloid. Recently the metabolic acidosis noted with CRF has been implicated as an additional factor contributing to the genesis of bone disease. Although metabolic acidosis might be the dominant factor in the cause of bone disease in some instances, more commonly this acid-base disturbance interacts with other factors contributing to the development of bone disease. The following article summarizes the data in support of an important role for metabolic acidosis in the genesis of bone disease in patients with CRF and presents our recommendations for treatment of uremic acidosis to prevent or treat the bone disease. C1 VA Greater Los Angeles Hlth Care Syst, Dialysis Unit 691 1111, Div Nephrol Med & Res Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. RP Kraut, JA (reprint author), VA Greater Los Angeles Hlth Care Syst, Dialysis Unit 691 1111, Div Nephrol Med & Res Serv, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 35 TC 30 Z9 30 U1 1 U2 2 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0894-0959 J9 SEMIN DIALYSIS JI Semin. Dial. PD JUL-AUG PY 2000 VL 13 IS 4 BP 261 EP 266 DI 10.1046/j.1525-139x.2000.00070.x PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 336QA UT WOS:000088313400011 PM 10923356 ER PT J AU Mitler, MM Harsh, J Hirshkowitz, M Guilleminault, C AF Mitler, Merrill M. Harsh, John Hirshkowitz, Max Guilleminault, Christian CA US Modafinil Narcolepsy Multictr TI Long-term efficacy and safety of modafinil (PROVIGIL (R)) for the treatment of excessive daytime sleepiness associated with narcolepsy SO SLEEP MEDICINE LA English DT Article DE Modafinil; Narcolepsy; Sleep disorders; Wakefulness; Quality of life; Disorders of excessive somnolence AB Objectives: To assess the long-term efficacy and safety of modafinil in patients with excessive daytime sleepiness (EDS) associated with narcolepsy. Background: Modafinil has been shown to be effective and well tolerated for treating EDS associated with narcolepsy in two large-scale, well-controlled, 9-week clinical trials. Methods: Four hundred and seventy eight adult patients with a diagnosis of narcolepsy who had completed one of two 9-week, double-blind, placebo-controlled, multicenter, clinical trials of modafinil were enrolled in two 40-week, open-label, extension studies. A flexible-dose regimen (i.e. 200, 300, or 400 mg daily) was followed in one study. In the second study, patients received 200 mg/day for 1 week, followed by 400 mg/day for 1 week. Investigators then prescribed either 200- or 400 mg doses for the duration of the study. Efficacy was evaluated using Clinical Global Impression of Change (CGI-C) scores, the Epworth Sleepiness Scale (ESS), and the 36-item Medical Outcomes Study health survey (SF-36). Adverse events were recorded. Data from the two studies were combined. Results: The majority of patients (similar to 75%) received 400 mg of modafinil daily. Disease severity improved in >80% of patients throughout the 40-week study. At weeks 2, 8, 24, and 40, disease severity was 'much improved' or 'very much improved' in 49, 58, 59, and 58% of patients, respectively. The mean (+/-SEM) ESS score improved significantly from 16.5 +/- 0.2 at open-label baseline to 12.4 +/- 0.2 at week 2 and remained at that level through week 40 (P<0.001). Quality of life scores at weeks 4, 8, 24, and 40 were significantly improved versus open-label baseline scores for six of the eight SF-36 domains (P<0.001). The most common treatment-related adverse events were headache (13%), nervousness (8%), and nausea (5%). Most adverse events were mild to moderate in nature. A total of 341 patients (71%) completed the studies. Forty-three patients (9.0%) discontinued treatment because of adverse events. Conclusions: Modafinil is effective for the long-term treatment of EDS associated with narcolepsy and significantly improves perceptions of general health. Modafinil is well tolerated, with no evidence of tolerance developing during 40 weeks of treatment. (C) 2000 Elsevier Science B. V. All rights reserved. C1 [Mitler, Merrill M.] Scripps Res Inst, Dept Neuropharmacol, La Jolla, CA 92037 USA. [Harsh, John] Forrest Gen Hosp, Sleep Disorders Ctr, Hattiesburg, MS USA. [Hirshkowitz, Max] VA Med Ctr, Sleep Diagnost Ctr, Houston, TX USA. [Guilleminault, Christian] Stanford Sleep Disorders Clin, Stanford, CA USA. RP Mitler, MM (reprint author), Scripps Clin Res Fdn, Sleep Disorders Ctr, 9834 Genesee Ave,Suite 328, La Jolla, CA 92037 USA. EM mitler@scripps.edu FU Cephalon, Inc. FX The studies reported were funded by Cephalon, Inc. The authors thank the following investigators who participated in the studies: Amand Beck, Albuquerque, NM; Philip M. Becker, Dallas, TX; Jed Black, Stanford, CA; Richard K. Bogan, Columbia, SC; Ronald D. Chervin, Ann Arbor, MI; Bruce Corser, Cincinnati, OH; Dudley S. Dinner, Cleveland, OH; Helene Emsellem, Chevy Chase, MD; Charles W. Erwin, Durham, NC; Simon Farrow, Las Vegas, NV; Neil T. Feldman, St. Petersburg, FL; Paul A. Fredrickson, Jacksonville, FL; June M. Fry, Philadelphia, PA; Philip M. Green, Kalamazoo, MI; Paul T. Gross, Burlington, MA; Christian Guilleminault, Stanford, CA; John Harsh, Hattiesburg, MI; Roza Hayduk, La Jolla, CA; Carl A. Houch, Birmington, AL; Gila Hertz, Huntington, NY; Max Hirshkowitz, Houston, TX; Vasudeva Iyer, Louisville, KY; Mark M. Mahowald, Minneapolis, MN; Merrill M. Mitler, La Jolla, CA; Allan Pack, Philadelphia, PA; Ralph Pascualy, Seattle, WA; Ralph W. Richter, Tulsa, OK; Ruzica K. Ristanovic, Chicago, IL; Ann E. Rogers, Ann Arbor, MI; Russell Rosenberg, Atlanta, GA; Pradeep K. Sahota, Columbia, MO; R. Bart Sangal, Troy, MI; Helmut S. Schmidt, Dublin, OH; Wolfgang W. Schmidt-Nowara, Albuquerque, NM; Jonathan R. L. Schwartz, Oklahoma City, OK; Lawrence Scrima, Aurora, CO; Shashidar M. Shettar, Birmingham, AL; Calvin Stafford, MD, Upland, PA; Robert Tearse, Eugene, OR; Stephen G. Thein Jr, San Diego, CA; Boris A. Vern, Chicago, IL; Joyce A. Walsleben, New York, NY; Andrew Winokur, Farmington, CT. NR 29 TC 75 Z9 76 U1 0 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1389-9457 J9 SLEEP MED JI Sleep Med. PD JUL 1 PY 2000 VL 1 IS 3 BP 231 EP 243 AR PII S1389-9457(00)00031-9 DI 10.1016/S1389-9457(00)00031-9 PG 13 WC Clinical Neurology SC Neurosciences & Neurology GA V22UQ UT WOS:000208300500008 ER PT J AU Hutcheson, K Kalafian, M Taylor, I Sagel, J Clyburn, B AF Hutcheson, K Kalafian, M Taylor, I Sagel, J Clyburn, B TI Neurocysticercosis SO SOUTHERN MEDICAL JOURNAL LA English DT Article C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Sagel, J (reprint author), Dept Med, 96 Jonathan Lucas St,POB 250623, Charleston, SC 29425 USA. NR 5 TC 3 Z9 3 U1 0 U2 0 PU SOUTHERN MEDICAL ASSN PI BIRMINGHAM PA 35 LAKESHORE DR PO BOX 190088, BIRMINGHAM, AL 35219 USA SN 0038-4348 J9 SOUTHERN MED J JI South.Med.J. PD JUL PY 2000 VL 93 IS 7 BP 666 EP 668 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 337DR UT WOS:000088342600004 PM 10923951 ER PT J AU Baumgarten, G Knuefermann, P Mann, DL AF Baumgarten, G Knuefermann, P Mann, DL TI Cytokines as emerging targets in the treatment of heart failure SO TRENDS IN CARDIOVASCULAR MEDICINE LA English DT Article ID TUMOR-NECROSIS-FACTOR; IDIOPATHIC DILATED CARDIOMYOPATHY; LEFT-VENTRICULAR DYSFUNCTION; FAILING HUMAN HEART; FACTOR-ALPHA GENE; CIRCULATING LEVELS; IMMUNE ACTIVATION; FACTOR RECEPTORS; NITRIC-OXIDE; EXPRESSION AB Recent studies have identified the importance of biologically active molecules such as neurohormones in disease progression in heart failure. More recently it has become apparent that in addition to neurohormones another portfolio of biologically active molecules termed cytokines are also expressed in the setting of heart failure. This article reviews recent clinical and experimental material which suggest that the cytokines such as tumor necrosis factor (TNF), interleukin-1 (IL-1) and interleukin-6 (IL-6) may represent another class of biologically active molecules that are responsible for the development and progression of heart failure. In addition, we also review the early results from clinical trials that have utilized various targeted anti-cytokine strategies in patients with heart failure. (C) 2001, Elsevier Science Inc. C1 VA Med Ctr, Dept Med, Winters Ctr Heart Failure Res, Cardiol Sect, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP Mann, DL (reprint author), VA Med Ctr, Dept Med, Winters Ctr Heart Failure Res, Cardiol Sect, 2002 Holcombe Blvd, Houston, TX 77030 USA. OI Mann, Douglas /0000-0002-2516-0145 FU NHLBI NIH HHS [R01 HL61543-01, R01 HL58081-01, P50 HL-O6H, HL-42250-10/10] NR 49 TC 42 Z9 44 U1 0 U2 2 PU ELSEVIER SCIENCE LONDON PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 1050-1738 J9 TRENDS CARDIOVAS MED JI Trends Cardiovasc. Med. PD JUL PY 2000 VL 10 IS 5 BP 216 EP 223 DI 10.1016/S1050-1738(00)00063-3 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 417PK UT WOS:000167843200007 PM 11282298 ER PT J AU Harendza, S Lovett, DH Stahl, RAK AF Harendza, S Lovett, DH Stahl, RAK TI The hematopoietic transcription factor PU.1 represses gelatinase A transcription in glomerular mesangial cells SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID STIMULATING FACTOR-RECEPTOR; MURINE TISSUE MACROPHAGES; BETA-C GENE; MATRIX METALLOPROTEINASE-2; IV COLLAGENASE; DNA-BINDING; EXPRESSION; PROMOTER; RAT; ACTIVATION AB The matrix metalloproteinase gelatinase A plays a key role in the evolution of glomerular injury and is a major contributing factor to the development of glomerulosclerosis, Prior studies have focused on a potent cis-acting enhancer element located in the near 5'-flanking region of the rat and human gelatinase A genes (Harendza, S., Pollock, A. S., Mertens, P. R., and Lovett, D. H. (1995) J. Biol. Chem. 270, 18286-18796; Mertens, P. R., Alfonso-Jaume, M. A., Steinmann, K., and Lovett, D. H. (1999) J. Am. Soc. Nephrol. 10, 2480-2487). Given the combinatorial nature of transcriptional regulation, we examined additional regions of the 5'-flanking region of the rat gelatinase A gene to identify further regulatory elements. In this study the identification of a silencing element located between -1903 and -1847 base pairs of the 5'-flanking region of the rat gelatinase A gene is reported. Sequence analysis, electrophoretic mobility studies, and transfection experiments demonstrate that a specific binding sequence for the hematopoietic transcription factor PU.1 is present within the silencing sequence. PU.1 activity is absolutely required for the expression of silencing activity within the context of transfected glomerular mesangial cells. Western blots identify the PU.1 protein within nuclear extracts of mesangial cells, and cotransfection with a PU.1 expression vector directly augments silencing activity. These studies underscore the complex patterns of gelatinase A transcriptional regulation and also strongly suggest that glomerular mesangial cells are ultimately derived from bone marrow cells. C1 Univ Hamburg, Dept Med, Div Nephrol, D-20246 Hamburg, Germany. Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, Dept Med, San Francisco, CA 94121 USA. RP Harendza, S (reprint author), Univ Hamburg, Krankenhaus Eppendorf, Med Klin, Abt Nephrol & Osteol, Pavillon 61,Martinistr 52, D-20246 Hamburg, Germany. FU NIDDK NIH HHS [DK 39776] NR 43 TC 13 Z9 13 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JUN 30 PY 2000 VL 275 IS 26 BP 19552 EP 19559 DI 10.1074/jbc.M001322200 PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 330AU UT WOS:000087941300018 PM 10867017 ER PT J AU Abboud, S Haile, DJ AF Abboud, S Haile, DJ TI A novel mammalian iron-regulated protein involved in intracellular iron metabolism SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID TRANSPORTER; NRAMP2; FERRITIN AB We have isolated and characterized a novel iron-regulated gene that is homologous to the divalent metal transporter 1 family of metal transporters. This gene, termed metal transporter protein (mtp1), is expressed in tissues involved in body iron homeostasis including the developing and mature reticuloendothelial system, the duodenum, and the pregnant uterus. MTP1 is also expressed in muscle and central nervous system cells in the embryo. At the subcellular level, MTP1 is localized to the basolateral membrane of the duodenal epithelial cell and a cytoplasmic compartment of reticuloendothelial system cells. Overexpression of MTP1 in tissue culture cells results in intracellular iron depletion. In the adult mouse, MTP1 expression in the liver and duodenum are reciprocally regulated. Iron deficiency induces MTP1 expression in the duodenum but down-regulates expression in the liver. These data indicate that MTP1 is an iron-regulated membrane-spanning protein that is involved in intracellular iron metabolism. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Hosp, S Texas Vet Hlth Syst, San Antonio, TX 78284 USA. RP Haile, DJ (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. FU NIDDK NIH HHS [R01DK53079, R03DK96009] NR 14 TC 778 Z9 810 U1 4 U2 22 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JUN 30 PY 2000 VL 275 IS 26 BP 19906 EP 19912 DI 10.1074/jbc.M000713200 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 330AU UT WOS:000087941300065 PM 10747949 ER PT J AU Rimbach, G Park, YC Guo, Q Moini, H Qureshi, N Saliou, C Takayama, K Virgili, F Packer, L AF Rimbach, G Park, YC Guo, Q Moini, H Qureshi, N Saliou, C Takayama, K Virgili, F Packer, L TI Nitric oxide synthesis and TNF-alpha secretion in RAW 264.7 macrophages - Mode of action of a fermented papaya preparation SO LIFE SCIENCES LA English DT Article DE nitric oxide; tumor necrosis factor-alpha; RAW 264.7 macrophages; fermented papaya preparation; bionormalizer (TM) ID TUMOR-NECROSIS-FACTOR; BIO-NORMALIZER SUPPLEMENTATION; CELL-LINE RAW-264.7; KAPPA-B ACTIVATION; SUPEROXIDE-DISMUTASE; PERITONEAL-MACROPHAGES; ESCHERICHIA-COLI; INTERFERON-GAMMA; OXIDATIVE DAMAGE; MESANGIAL CELLS AB Macrophage inducible nitric oxide synthase is able to generate massive amounts of nitric oxide (NO) which contributes to the host immune defense against viruses and bacteria. Monocyte-macrophages stimulated with the bacterial wall component lipopolysaccharide (LPS) and cytokines such as interferon-gamma (IFN-gamma) express the inducible form of nitric oxide synthase (iNOS). Furthermore, tumor necrosis factor-alpha (TNF-alpha) is one of the central regulatory cytokines in macrophage antimicrobial activity and synergizes with IFN-gamma in the induction of NO synthesis. Because of its pivotal role in both antimicrobial and tumoricidal activities of macrophages, a significant effort has focused on developing therapeutic agents that regulate NO production. In the present study fermented papaya preparation (FPP) is shown to exert both immunomodulatory and antioxidant activity in the macrophage cell line RAW 264.7. Interestingly, a low and a high molecular weight fraction (LMF and HMF, respectively) of FPP exhibited different activity patterns. FPP fractions alone did not affect NO production, However in the presence of IFN-gamma, both LMF and HMF significantly increased iNOS activity and nitrite as well as nitrate accumulation. NO radical formation measured in real-time by electron paramagnetic resonance spectroscopy was higher in the presence of LMF and IFN-gamma. On the contrary, iNOS mRNA levels were enhanced further with HMF than with LMF Moreover, LMF displayed a stronger superoxide anion scavenging activity than HMF. In the presence of IFN-gamma, both FPP fractions stimulated TNF-alpha secretion. However in non-stimulated macrophages, TNF-alpha secretion was enhanced by HMF only. Since water-soluble FPP fractions contained no lipid A, present data indicate that FPP is a macrophage activator which augments nitric oxide synthesis and TNF-alpha secretion independently of lipopolysaccharides. (C) 2000 Elsevier Science Inc. All rights reserved. C1 Univ Calif Berkeley, Dept Cell & Mol Biol, Berkeley, CA 94720 USA. William S Middleton Mem Vet Hosp, Mycobacteriol Res Lab, Madison, WI USA. Natl Inst Nutr, Rome, Italy. RP Packer, L (reprint author), Univ Calif Berkeley, Dept Cell & Mol Biol, 251 Life Sci Addit, Berkeley, CA 94720 USA. RI Rimbach, Gerald/A-7178-2011 OI Rimbach, Gerald/0000-0001-7888-4684 NR 51 TC 35 Z9 35 U1 1 U2 6 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0024-3205 J9 LIFE SCI JI Life Sci. PD JUN 30 PY 2000 VL 67 IS 6 BP 679 EP 694 DI 10.1016/S0024-3205(00)00664-0 PG 16 WC Medicine, Research & Experimental; Pharmacology & Pharmacy SC Research & Experimental Medicine; Pharmacology & Pharmacy GA 332LZ UT WOS:000088076900009 PM 12659174 ER PT J AU Weaver, WD Reisman, MA Griffin, JJ Buller, CE Leimgruber, PP Henry, T D'Haem, C Clark, VL Martin, JS Cohen, DJ Neil, N Every, NR AF Weaver, WD Reisman, MA Griffin, JJ Buller, CE Leimgruber, PP Henry, T D'Haem, C Clark, VL Martin, JS Cohen, DJ Neil, N Every, NR CA OPUS-1 Investigators TI Optimum percutaneous transluminal coronary angioplasty compared with routine stent strategy trial (OPUS-1): a randomised trial SO LANCET LA English DT Article ID ANGIOGRAPHIC FOLLOW-UP; BALLOON ANGIOPLASTY; ARTERY DISEASE; THREATENED CLOSURE; IMPLANTATION; RESTENOSIS; DISSECTION; OUTCOMES AB Background Whether routine implantation of coronary stents is the best strategy to treat flow-limiting coronary stenoses is unclear. An alternative approach is to do balloon angioplasty and provisionally use stents only to treat suboptimum results. We did a multicentre trial to compare the outcomes of patients treated with these strategies. Methods We randomly assigned 479 patients undergoing single-vessel coronary angioplasty routine stent implantation or initial balloon angioplasty and provisional stenting. We followed up patients for 6 months to determine the composite rate of death, myocardial infarction, cardiac surgery, and target-vessel revascularisation. Results Stents were implanted in 227 (98.7%) of the patients assigned routine stenting. 93 (37%) patients assigned balloon angioplasty had at least one stent placed because of suboptimum angioplasty results. At 6 months the composite endpoint was significantly lower in the routine stent strategy (14 events, 6.1%) than with the strategy of balloon angioplasty with provisional stenting (37 events, 14.9%, p=0.003). The cost of the initial revascularisation procedure was higher than when a routine stent strategy was used (US$389 vs $339, p<0.001) but at 6 months, average per-patient hospital costs did not differ ($10 206 vs $10 490). Bootstrap replication of 6-month cost data showed continued economic benefit of the routine stent strategy. Interpretation Routine stent implantation leads to better acute and long-term clinical outcomes at a cost similar to that of initial balloon angioplasty with provisional stenting. C1 Henry Ford Hlth Syst, Inst Heart & Vasc, Div Cardiovasc Med, Detroit, MI 48202 USA. Swedish Med Ctr, Seattle, WA USA. Virginia Beach Med Ctr, Virginia Beach, VA USA. Vancouver Hosp & Med Ctr, Vancouver, BC, Canada. Heart Inst Spokane, Spokane, WA USA. Hennepin Cty Med Ctr, Minneapolis, MN 55415 USA. Michigan Capital Med Ctr, Lansing, MI USA. Beth Israel Hosp, Boston, MA 02215 USA. Univ Washington, Med Ctr, Seattle, WA 98195 USA. Virginia Mason Med Ctr, Seattle, WA 98101 USA. VA Puget Sound Healthcare Syst, Seattle, WA USA. RP Weaver, WD (reprint author), Henry Ford Hlth Syst, Inst Heart & Vasc, Div Cardiovasc Med, 2799 W Grand Blvd, Detroit, MI 48202 USA. RI Neil, Nancy/I-4913-2012 OI Neil, Nancy/0000-0002-1442-028X NR 29 TC 70 Z9 71 U1 0 U2 1 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JUN 24 PY 2000 VL 355 IS 9222 BP 2199 EP 2203 DI 10.1016/S0140-6736(00)02403-X PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 327DX UT WOS:000087779000011 PM 10881893 ER PT J AU Mummidi, S Bamshad, M Ahuja, SS Gonzalez, E Feuillet, PM Begum, K Galvis, MC Kostecki, V Valente, AJ Murthy, KK Haro, L Dolan, MJ Allan, JS Ahuja, SK AF Mummidi, S Bamshad, M Ahuja, SS Gonzalez, E Feuillet, PM Begum, K Galvis, MC Kostecki, V Valente, AJ Murthy, KK Haro, L Dolan, MJ Allan, JS Ahuja, SK TI Evolution of human and non-human primate CC chemokine receptor 5 gene and mRNA - Potential roles for haplotype and mRNA diversity, differential haplotype-specific transcriptional activity, and altered transcription factor binding to polymorphic nucleotides in the pathogenesis of HIV-1 and Simian immunodeficiency virus SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID NF-KAPPA-B; AFRICAN-GREEN MONKEYS; DISEASE PROGRESSION; MESSENGER-RNA; 5'-END HETEROGENEITY; PROMOTER REGION; ANIMAL-MODELS; INFECTION; PROTEINS; ENTRY AB Polymorphisms in CC chemokine receptor 5 (CCR5), the major coreceptor of human immunodeficiency virus 1 (HIV-1) and simian immunodeficiency virus (SIV), have a major influence on HIV-1 transmission and disease progression. The effects of these polymorphisms may, in part, account for the differential pathogenesis of HIV-1 (immunosuppression) and SIV (natural resistance) in humans and non-human primates, respectively. Thus, understanding the genetic basis underlying species-specific responses to HIV-1 and SIV could reveal new anti-HIV-1 therapeutic strategies for humans. To this end, we compared CCR5 structure/evolution and regulation among humans, apes, Old World Monkeys, and New World Monkeys. The evolution of the CCR5 cis-regulatory region versus the open reading frame as well as among different domains of the open reading frame differed from one another. CCR5 cis-regulatory region sequence variation in humans was substantially higher than anticipated. Based on this variation, CCR5 haplotypes could be organized into seven evolutionarily distinct human haplogroups (HH) that we designated HHA, -B, -C, -D, -E, -F, and -G. HHA haplotypes were defined as ancestral to all other haplotypes by comparison to the CCR5 haplotypes of non-human primates. Different human and non-human primate CCR5 haplotypes were associated with differential transcriptional regulation, and various polymorphisms resulted in modified DNA-nuclear protein interactions, including altered binding of members of the NF-KB family of transcription factors. We identified novel CCR5 untranslated mRNA sequences that were conserved in human and non-human primates. In some primates, mutations at exon-intron boundaries caused loss of expression of selected CCR5 mRNA isoforms or production of novel mRNA isoforms. Collectively, these findings suggest that the response to HIV-1 and SN infection in primates may have been driven, in part, by evolution of the elements controlling CCR5 transcription and translation. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie L Murphy Div, Dept Med, San Antonio, TX 78229 USA. Univ Utah, Eccles Inst Human Genet, Dept Pediat, Salt Lake City, UT 84112 USA. SW Fdn Biomed Res, Dept Virol & Immunol, San Antonio, TX 78228 USA. Univ Texas, Dept Life Sci, San Antonio, TX 78249 USA. Wilford Hall USAF Med Ctr, Infect Dis Serv, Lackland AFB, San Antonio, TX 78236 USA. RP Ahuja, SK (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. RI Mummidi, Srinivas/C-1004-2008 OI Mummidi, Srinivas/0000-0002-4068-6380 FU NIAID NIH HHS [R01-AI41396, R01-AI43279, R29-AI46326] NR 67 TC 116 Z9 118 U1 1 U2 4 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JUN 23 PY 2000 VL 275 IS 25 BP 18946 EP 18961 DI 10.1074/jbc.M000169200 PG 16 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 327VZ UT WOS:000087815900046 PM 10747879 ER PT J AU Kohen, R Heidmann, DEA Anthony, J White, SS Hamblin, MW Szot, P AF Kohen, R Heidmann, DEA Anthony, J White, SS Hamblin, MW Szot, P TI Changes in 5-HT7 serotonin receptor mRNA expression with aging in rat brain SO MOLECULAR BRAIN RESEARCH LA English DT Article DE in situ hybridization histochemistry; aging; circadian rhythm; hippocampus; spatial learning; psychiatric disorders ID AUTORADIOGRAPHIC ANALYSIS; MOLECULAR-CLONING; F-18 ALTANSERIN; GENE-EXPRESSION; BINDING SITES; AGE; HIPPOCAMPUS; ADRENALECTOMY; HYPOTHALAMUS; STIMULATION AB We examined 5-HT7 receptor mRNA expression with in situ hybridization histochemistry in the brains of young (3 months), middle-aged (12 months) and old rats (24 months). In the ventral CA3 area of the hippocampus 5-HT7 mRNA expression is reduced by approximately 30% between young and middle age without further decline between middle and old age. In other brain areas 5-HT7 mRNA expression is unaffected by age. (C) 2000 Elsevier Science B.V. All rights reserved. C1 Ctr Geriatr Res Educ & Clin, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Kohen, R (reprint author), Ctr Geriatr Res Educ & Clin, VA Puget Sound Hlth Care Syst, 182B,1660 S Columbian Way, Seattle, WA 98108 USA. NR 31 TC 11 Z9 11 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0169-328X J9 MOL BRAIN RES JI Mol. Brain Res. PD JUN 23 PY 2000 VL 79 IS 1-2 BP 163 EP 168 DI 10.1016/S0169-328X(00)00103-0 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 344ZM UT WOS:000088791000017 ER PT J AU Hickey, RW Zhu, RL Alexander, HL Jin, KL Stetler, RA Chen, J Kochanek, PM Graham, SH AF Hickey, RW Zhu, RL Alexander, HL Jin, KL Stetler, RA Chen, J Kochanek, PM Graham, SH TI 10 kD mitochondrial matrix heat shock protein mRNA is induced following global brain ischemia in the rat SO MOLECULAR BRAIN RESEARCH LA English DT Article DE asphyxia; cardiac arrest; chaperonin; west shock protein; ischemia ID CEREBRAL-ISCHEMIA; ESCHERICHIA-COLI; MESSENGER-RNA; CHAPERONES; INDUCTION; ARREST; HSP10; MODEL AB Heat shock proteins (HSP's) are a family of highly conserved proteins whose expression is increased by stress. The expression of many HSP's is induced in neurons by ischemia; however, the response of the 10 kDa mitochondrial matrix HSP (HSP10) is less well characterized. To address this issue, asphyxial cardiac arrest was induced in 28 male Sprague-Dawley rats. Northern blot analysis revealed that hsp10 mRNA was increased 3.7-fold in asphyxiated rats compared to sham-operated controls. In situ hybridization demonstrated increased mRNA in the cortex, septal nuclei, hippocampus, thalamic nuclei, purkinje cell layer of the cerebellum, and isolated brainstem nuclei of asphyxiated rats. The increase of mRNA was most robust 8 h after the injury but remained increased for 72 h. These results show that hsp10 mRNA is increased following asphyxial cardiac arrest in rats and suggest that hsp10 could be another determinate of neuronal survival after ischemia. (C) 2000 Elsevier Science B.V. All rights reserved. C1 Univ Pittsburgh, Childrens Hosp Pittsburgh, Dept Pediat, Div Pediat Emergency Med, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Anesthesia Crit Care Med, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Safar Ctr Resuscitat Res, Pittsburgh, PA 15213 USA. VA Pittsburgh Hlth Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Neurol, Pittsburgh, PA 15213 USA. RP Hickey, RW (reprint author), Univ Pittsburgh, Childrens Hosp Pittsburgh, Dept Pediat, Div Pediat Emergency Med, 3705 5th Ave, Pittsburgh, PA 15213 USA. EM hickeyr@pitt.edu RI Kochanek, Patrick/D-2371-2015 OI Kochanek, Patrick/0000-0002-2627-913X FU NINDS NIH HHS [1PO1NS35965] NR 20 TC 7 Z9 9 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0169-328X J9 MOL BRAIN RES JI Mol. Brain Res. PD JUN 23 PY 2000 VL 79 IS 1-2 BP 169 EP 173 PG 5 WC Neurosciences SC Neurosciences & Neurology GA 344ZM UT WOS:000088791000018 PM 10925156 ER PT J AU Ghosh-Choudhury, N Woodruff, K Qi, WB Celeste, A Abboud, SL Choudhury, GG AF Ghosh-Choudhury, N Woodruff, K Qi, WB Celeste, A Abboud, SL Choudhury, GG TI Bone morphogenetic protein-2 blocks MDA MB 231 human breast cancer cell proliferation by inhibiting cyclin-dependent kinase-mediated retinoblastoma protein phosphorylation SO BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS LA English DT Article DE BMP-2; pRb; p21; breast cancer cells ID EPIDERMAL GROWTH-FACTOR; DNA-SYNTHESIS; MESANGIAL CELLS; FACTOR RECEPTOR; EGF-RECEPTOR; IN-VIVO; FAMILY; P21; ACTIVATION; REGULATORS AB Bone morphogenetic protein-2 (BMP-2) has been shown to act as an antiproliferative agent for a number of different cell types. We show that BMP-2 dose-dependently inhibits growth of MDA MB 231 human breast cancer cells. Epidermal growth factor (EGF) stimulates DNA synthesis and entry of these cells into the S-phase. BMP-2 inhibits EGF-induced DNA synthesis by arresting them in G1 phase of the cell cycle. BMP-2 increases the level of cyclin kinase inhibitor p21. Furthermore, we show that exposure of MDA MB 231 cells to BMP-2 stimulates association of pal with cyclin D1 and with cyclin E resulting in the inhibition of their associated kinase activities. Finally, BMP-2 treatment is found to cause hypophosphorylation of the retinoblastoma protein (pRb), a key regulator of cell cycle progression. Our data provide a mechanism for the antiproliferative effect of BMP-2 in the breast cancer cells. (C) 2000 Academic Press. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, GRECC, San Antonio, TX USA. Genet Inst, Boston, MA USA. RP Ghosh-Choudhury, N (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. FU NIDDK NIH HHS [DK-50190] NR 35 TC 67 Z9 71 U1 0 U2 2 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0006-291X J9 BIOCHEM BIOPH RES CO JI Biochem. Biophys. Res. Commun. PD JUN 16 PY 2000 VL 272 IS 3 BP 705 EP 711 DI 10.1006/bbrc.2000.2844 PG 7 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA 327HD UT WOS:000087787700015 PM 10860819 ER PT J AU Yuan, PQ Yang, H AF Yuan, PQ Yang, H TI Localization of thyroid hormone receptor beta 2 in the ventral medullary neurons that synthesize thyrotropin-releasing hormone SO BRAIN RESEARCH LA English DT Article DE triiodothyronine; negative feedback; Raphe pallidus; Raphe obscurus; parapyramidal region ID DORSAL VAGAL COMPLEX; IN-SITU HYBRIDIZATION; MESSENGER-RNA; PARAVENTRICULAR NUCLEUS; GENE-EXPRESSION; RAPHE PALLIDUS; SUBSTANCE-P; NEGATIVE REGULATION; RAT HYPOTHALAMUS; NERVOUS-SYSTEM AB Altered thyroid statuses are associated with autonomic disorders. Thyrotropin-releasing hormone (TRH) synthesized in medullary raphe pallidus (Rpa), raphe obscurus (Rob) and the parapyramidal regions (PPR) regulates vagal and sympathetic preganglionic motoneurons. Hypothyroidism increased TRH gene expression and c-Fos immunoreactivity (IR) in these nuclei. Whether these increases represent a direct action of thyroid hormone was studied by detecting the presence of thyroid hormone receptor beta 2 (TR beta 2) in pro-TRH-synthesizing neurons in the Rpa. Rob and the PPR using immunohistochemistry with specific TR beta 2 antiserum and in situ hybridization with digoxigenin-labeled pro-TRH cRNA probe. TR beta 2 IR was widely distributed throughout the medulla and primarily localized within the cell nuclei. Particularly intense immunostaining was presented in the Rpa, Rob and the PPR neurons. The combination of immunohistochemistry with in situ hybridization revealed that all pro-TRH mRNA-positive neurons in these ventral medullary nuclei were also TR beta 2 IR positive. The numbers of TR beta 2 IR-positive neurons in each nucleus were identical in both euthyroid rats and hypothyroid rats induced by 6-n-propyl-2-thiouracil in drinking water for 4 weeks. The finding that TR beta 2 localized in pro-TRH-synthesizing neurons in the ventral medullary nuclei provides an anatomical substrate for a direct thyroid hormone action on these neurons in the regulation of TRH gene expression, which may contribute to the altered autonomic activity in different thyroid statuses. (C) 2000 Elsevier Science B.V. All rights reserved. C1 Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Dept Med, Div Digest Dis, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Brain Res Inst, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. RP Yang, H (reprint author), Univ Calif Los Angeles, CURE Digest Dis Res Ctr, Dept Med, Div Digest Dis, Bldg 115,Room 203,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK 41301, DK 50255] NR 52 TC 4 Z9 4 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD JUN 16 PY 2000 VL 868 IS 1 BP 22 EP 30 DI 10.1016/S0006-8993(00)02251-4 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 327EK UT WOS:000087780500003 PM 10841884 ER PT J AU Vaccarino, V Parsons, L Every, NR Barron, HV Krumholz, HM AF Vaccarino, V Parsons, L Every, NR Barron, HV Krumholz, HM CA Natl Registry Myocardial Infarct TI Impact of history of diabetes mellitus on hospital mortality in men and women with first acute myocardial infarction SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID SEX-DIFFERENCES; HEART-DISEASE; HYPERGLYCEMIA; PREVALENCE; SURVIVAL; DISCHARGE; RISK AB This study addresses the question of whether a higher susceptibility to the adverse effects of diabetes can explain the higher hospital mortality of young and middle-aged women compared with men. Younger women had a higher hospital mortality than men, irrespective of diabetes status: effect modification due to diabetes did not play a role in the higher short-term mortality risk of young and middle-aged women compared with men. C1 Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, New Haven, CT 06520 USA. Yale Univ, Sch Med, Dept Med Cardiol, New Haven, CT 06520 USA. VA Puget Sound Healthcare Syst, Hlth Serv Res & Dev Field Program, Seattle, WA USA. Univ Washington, Sch Med, Div Cardiol, Cardiovasc Outcomes Res Ctr, Seattle, WA 98195 USA. Univ Calif San Francisco, Div Cardiol, S San Francisco, CA 94080 USA. Genentech Inc, Div Med Affairs, S San Francisco, CA 94080 USA. Yale New Haven Hosp, Ctr Outcomes Res & Evaluat, New Haven, CT USA. RP Vaccarino, V (reprint author), Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, 60 Coll St,POB 208034, New Haven, CT 06520 USA. NR 20 TC 40 Z9 42 U1 0 U2 2 PU EXCERPTA MEDICA INC PI NEW YORK PA 245 WEST 17TH STREET, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD JUN 15 PY 2000 VL 85 IS 12 BP 1486 EP + DI 10.1016/S0002-9149(00)00800-6 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 322KB UT WOS:000087507800017 PM 10856398 ER PT J AU Starkebaum, G AF Starkebaum, G TI Leukemia of large granular lymphocytes and rheumatoid arthritis SO AMERICAN JOURNAL OF MEDICINE LA English DT Editorial Material ID FELTYS-SYNDROME; METHOTREXATE TREATMENT; T-CELLS; EXPANSIONS; NEUTROPENIA C1 Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Starkebaum, G (reprint author), Univ Washington, Sch Med, Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 21 TC 7 Z9 7 U1 0 U2 1 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD JUN 15 PY 2000 VL 108 IS 9 BP 744 EP 745 DI 10.1016/S0002-9343(00)00386-7 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 338YG UT WOS:000088450400010 PM 10924655 ER PT J AU McElroy, SL Suppes, T Keck, PE Frye, MA Denicoff, KD Altshuler, LL Brown, ES Nolen, WA Kupka, RW Rochussen, J Leverich, GS Post, RM AF McElroy, SL Suppes, T Keck, PE Frye, MA Denicoff, KD Altshuler, LL Brown, ES Nolen, WA Kupka, RW Rochussen, J Leverich, GS Post, RM TI Open-label adjunctive topiramate in the treatment of bipolar disorders SO BIOLOGICAL PSYCHIATRY LA English DT Article DE topiramate; bipolar disorders; mania; cycling; weight ID REFRACTORY PARTIAL EPILEPSY; PLACEBO-CONTROLLED TRIAL; DOSE-RANGING TRIAL; DOUBLE-BLIND; CALCIUM INFLUX; DAILY DOSAGES; LITHIUM; MONOTHERAPY; SEIZURES; CORTEX AB Background: To preliminarily explore the spectrum of effectiveness and tolerability of the new antiepileptic drug topiramate in bipolar disorder, we evaluated the response of 56 bipolar outpatients in the Stanley Foundation Bipolar Outcome Network (SFBN) who had been treated with adjunctive topiramate in an open-label, naturalistic fashion. Methods: In this case series, response to topiramate was assessed every 2 weeks for the first 3 months according to standard ratings in the SFBN, and monthly thereafter while patients remained on topiramate. Patients' weights, body mass indices (BMIs), and side effects were also assessed. Results: Of the 54 patients who completed at least 2 weeks of open-label, add-on topiramate treatment, 30 had manic, mixed, or cycling symptoms, 11 had depressed symptoms, and 13 were relatively euthymic at the time topiramate was begun. Patients who had been initially treated for manic symptoms displayed significant reductions in standard ratings scores after 4 weeks, after 10 weeks, and at the last evaluation. Those patients who were initially depressed or treated while euthymic showed no significant changes. Patients as a group displayed significant decreases in weight and BMI from topiramate initiation to week 4, to week 10, and to the last evaluation. The most common adverse side effects were neurologic and gastrointestinal. Conclusion: These preliminary open observations of adjunctive topiramate treatment suggest that it may have antimanic or anticycling effects in some patients with bipolar disorder, and may be associated in some patients with bipolar disorder, and may be associated with appetite suppression and weight loss that is often viewed as beneficial by the patient and clinician. Controlled studies of topiramate's acute and long-term efficacy and side-effects in bipolar disorder appear warranted. (C) 2000 Society of Biological Psychiatry. C1 Univ Cincinnati, Coll Med, Biol Psychiat Program ML559, Stanley Fdn Bipolar Outcome Network, Cincinnati, OH 45267 USA. Univ Texas, SW Med Ctr, Dallas, TX 75230 USA. Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90024 USA. W Los Angeles VA Med Ctr, Los Angeles, CA 90024 USA. NIMH, Biol Psychiat Branch, Bethesda, MD 20892 USA. Univ Utrecht, Med Ctr, Utrecht, Netherlands. HC Rumke Grp, Utrecht, Netherlands. Stanley Fdn, Data Coordinating Ctr, Bethesda, MD USA. RP McElroy, SL (reprint author), Univ Cincinnati, Coll Med, Biol Psychiat Program ML559, Stanley Fdn Bipolar Outcome Network, 231 Bethesda Ave, Cincinnati, OH 45267 USA. RI Nolen, Willem/E-9006-2014 NR 36 TC 165 Z9 173 U1 1 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD JUN 15 PY 2000 VL 47 IS 12 BP 1025 EP 1033 DI 10.1016/S0006-3223(99)00316-9 PG 9 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 324CK UT WOS:000087604100002 PM 10862801 ER PT J AU Heinrich, MC Silvey, KV Stone, S Zigler, AJ Griffith, DJ Montalto, M Chai, L Zhi, Y Hoatlin, ME AF Heinrich, MC Silvey, KV Stone, S Zigler, AJ Griffith, DJ Montalto, M Chai, L Zhi, Y Hoatlin, ME TI Posttranscriptional cell cycle-dependent regulation of human FANCC expression SO BLOOD LA English DT Article ID ANEMIA GROUP-C; ORNITHINE DECARBOXYLASE; NUCLEAR-LOCALIZATION; FUNCTIONAL-ACTIVITY; MAMMALIAN-CELLS; FANCONIS ANEMIA; PROTEIN; COMPLEX; GENE; FAC AB The Fanconi Anemia (FA) Group C complementation group gene (FANCC) encodes a protein, FANCC, with a predicted M-r of 63000 daltons, FANCC is found in both the cytoplasmic and the nuclear compartments and interacts with certain other FA complementation group proteins as well as with non-FA proteins, Despite intensive investigation, the biologic roles of FANCC and of the other cloned FA gene products (FANCA and FANCG) remain unknown. As an approach to understanding FANCC function. rye have studied the molecular FANCC expression, We found that although FANCC mRNA levels are constant throughout the cell cycle, FANCC is expressed in a cell cycle-dependent manner, with the lowest levels seen in cells synchronized at the G1/S boundary and the highest levels in the An-phase. Cell cycle-dependent regulation occurred despite deletion of the 5' and 3' FANCC untranslated regions, indicating that information in the FANCC coding sequence is sufficient to mediate cell cycle-dependent regulation. Moreover, inhibitors of proteasome function blocked the observed regulation. We conclude that FANCC expression is con-trolled by post-transcriptional mechanisms that are proteasome dependent. Recent work has demonstrated that the functional activity of FA proteins requires the physical interaction of at least FANCA, FANCC, and FANCG, and possibly of other FA and non-FA proteins. Our observation of dynamic control of FANCC expression by the proteasome has important implications for understanding the molecular regulation of the multiprotein complex. (C) 2000 by The American Society of nematology. C1 Portland Vet Affairs Med Ctr, Portland, OR 97207 USA. Oregon Hlth Sci Univ, Dept Med, Div Hematol & Med Oncol, Portland, OR 97201 USA. RP Heinrich, MC (reprint author), Portland Vet Affairs Med Ctr, 3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. FU NHLBI NIH HHS [HL56045] NR 55 TC 18 Z9 18 U1 0 U2 0 PU AMER SOC HEMATOLOGY PI WASHINGTON PA 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA SN 0006-4971 J9 BLOOD JI Blood PD JUN 15 PY 2000 VL 95 IS 12 BP 3970 EP 3977 PG 8 WC Hematology SC Hematology GA 325ME UT WOS:000087678700046 PM 10845936 ER PT J AU Bodenheimer, C Kerrigan, AJ Garber, SL Monga, TN AF Bodenheimer, C Kerrigan, AJ Garber, SL Monga, TN TI Sexuality in persons with lower extremity amputations SO DISABILITY AND REHABILITATION LA English DT Article ID ADULT AMPUTEES AB Purpose: There is a paucity of information regarding sexual functioning in persons with lower extremity amputations. The purpose of this study was to describe sexual and psychological functioning and health status in persons with lower extremity amputation. Methods: Self-report surveys assessed sexual functioning (Derogatis Inventory), depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory), and health status (Health Status Questionnaire) in a convenience sample of 30 men with lower extremity amputations. Mean age of the participants was 57 years (range 32-79). Mean duration since amputation was 23 months (range 3-634 months). Twenty one subjects (70 %) had trans-tibial and seven subjects (23 %) had trans-femoral amputations. Results: A majority of subjects were experiencing problems in several domains of sexual functioning. Fifty three percent (n = 16) of the subjects were engaged in sexual intercourse or oral sex at least once a month. Twenty seven percent (n = 8) were masturbating at least once a month. Nineteen subjects (63 %) reported orgasmic problems and 67% were experiencing erectile difficulties. Despite these problems, interest in sex was high in over 90 % of the subjects. There was no evidence of increased prevalence of depression or anxiety in these subjects when compared to other outpatient adult populations. Conclusions: Sexual problems were common in the subjects studied. Despite these problems, interest in sex remained high. Few investigations have been directed toward identifying the psychological and social factors that may contribute to these problems and more research with a larger population is needed in this area. C1 Houston VAMC, Houston, TX 77030 USA. RP Bodenheimer, C (reprint author), Houston VAMC, 2020 Holcombe Blvd, Houston, TX 77030 USA. NR 23 TC 33 Z9 33 U1 1 U2 5 PU TAYLOR & FRANCIS LTD PI LONDON PA 11 NEW FETTER LANE, LONDON EC4P 4EE, ENGLAND SN 0963-8288 J9 DISABIL REHABIL JI Disabil. Rehabil. PD JUN 15 PY 2000 VL 22 IS 9 BP 409 EP 415 PG 7 WC Rehabilitation SC Rehabilitation GA 331KQ UT WOS:000088018600003 PM 10894204 ER PT J AU Chung, N Jenkins, G Hannun, YA Heitman, J Obeid, LM AF Chung, N Jenkins, G Hannun, YA Heitman, J Obeid, LM TI Sphingolipids signal heat stress-induced ubiquitin-dependent proteolysis SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID PLASMA-MEMBRANE PROTEIN; YEAST URACIL PERMEASE; SACCHAROMYCES-CEREVISIAE; DEGRADATION; GENE; RESISTANCE; MUTANT; MULTIUBIQUITINATION; ENDOCYTOSIS; INHIBITION AB Sphingolipids are essential eukaryotic membrane lipids that are structurally and metabolically conserved through evolution. Sphingolipids have also been proposed to regulate eukaryotic stress responses as novel second messengers. Here we show that, in Saccharomyces cerevisiae, phytosphingosine, a putative sphingolipid second messenger, mediates heat stress signaling and activates ubiquitin-dependent proteolysis via the endocytosis vacuolar degradation and 26 S proteasome pathways. Inactivation of serine palmitoyltransferase, a key enzyme in generating endogenous phytosphingosine, prevents proteolysis during heat stress. Addition of phytosphingosine bypasses the requirement for serine palmitoyltransferase and restores proteolysis, Phytosphingosine-induced proteolysis requires multiubiquitin chain formation through the stress-responsive lysine 63 residue of ubiquitin, We propose that heat stress increases phytosphingosine and activates ubiquitin-dependent proteolysis. C1 Med Univ S Carolina, Ralph H Johnson Vet Adm, Charleston, SC 29403 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29403 USA. Med Univ S Carolina, Dept Biochem, Charleston, SC 29403 USA. Duke Univ, Dept Pharmacol & Canc Biol, Program Mol Canc Biol, Med Ctr, Durham, NC 27710 USA. Duke Univ, Dept Cell Biol, Med Ctr, Durham, NC 27710 USA. Duke Univ, Dept Genet, Med Ctr, Durham, NC 27710 USA. Duke Univ, Dept Microbiol, Med Ctr, Durham, NC 27710 USA. Duke Univ, Dept Med, Med Ctr, Durham, NC 27710 USA. Duke Univ, Dept Med, Howard Hughes Med Inst, Med Ctr, Durham, NC 27710 USA. RP Obeid, LM (reprint author), Med Univ S Carolina, Ralph H Johnson Vet Adm, Charleston, SC 29403 USA. OI obeid, lina/0000-0002-0734-0847 FU NIA NIH HHS [AG12467]; NIAID NIH HHS [AI41937]; NIGMS NIH HHS [GM43825] NR 40 TC 85 Z9 88 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JUN 9 PY 2000 VL 275 IS 23 BP 17229 EP 17232 DI 10.1074/jbc.C000229200 PG 4 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 321ZJ UT WOS:000087485000003 PM 10764732 ER PT J AU D'Souza, I Schellenberg, GD AF D'Souza, I Schellenberg, GD TI Determinants of 4-repeat tau expression - coordination between enhancing and inhibitory splicing sequences for exon 10 inclusion SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID IMMUNODEFICIENCY-VIRUS TYPE-1; MULTIPLE-SYSTEM TAUOPATHY; MICROTUBULE-ASSOCIATED PROTEINS; FAMILIAL PRESENILE-DEMENTIA; FRONTOTEMPORAL DEMENTIA; REGULATORY ELEMENTS; ALZHEIMERS-DISEASE; FTDP-17 MUTATIONS; NERVOUS-SYSTEM; CHROMOSOME-17 AB Mutations in the tau gene are pathogenic causing autosomal dominant frontotemporal dementia with Parkinsonism-chromosome 17 type (FTDP-17). Some mutations in tau exon 10 (E10) and immediately adjacent sequences cause disease by altering E10 splicing. To determine the mechanism of normal E10 splicing regulation and how FTDP-17 mutations alter splicing, mutational analysis of E10 was performed. The results show that E10 contains a complex array of both enhancer and inhibitor cia-acting elements that modulate usage of a weak 5' splice site. The 5' end of E10 contains a previously unrecognized multipartite exon splicing enhancer (ESE) composed of an SC35-like binding sequence, a purine-rich sequence, and an AC-rich element. Downstream of this ESE is a purine-rich exon splicing inhibitor. Intronic sequences immediately downstream of E10 also are inhibitory. The results support an alternative model in which I10 inhibitory sequences appear to function as a linear sequence. The cia-elements described are not redundant, and all appear required for normal E10 splicing. Results with double mutations demonstrate that the ESE and the intronic inhibitory element collaborate to regulate splicing. Thus splicing of tau E10 is regulated by a complex set of cia-acting elements that span nearly the entire exon and also include intronic sequences. C1 Seattle Div, Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Dept Med, Div Gerontol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Div Geriatr Med, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Pharmacol, Seattle, WA 98195 USA. RP Schellenberg, GD (reprint author), Seattle Div, Vet Affairs Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. FU NIA NIH HHS [R01 AG11762] NR 35 TC 90 Z9 91 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD JUN 9 PY 2000 VL 275 IS 23 BP 17700 EP 17709 DI 10.1074/jbc.M909470199 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 321ZJ UT WOS:000087485000070 PM 10748133 ER PT J AU Singh, N Singh, PN Hershman, JM AF Singh, N Singh, PN Hershman, JM TI Effect of calcium carbonate on the absorption of levothyroxine SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID INTESTINAL-ABSORPTION; ALUMINUM HYDROXIDE; THYROXINE; HYPOTHYROIDISM; SUCRALFATE; EFFICACY; THERAPY AB Context The effect of calcium carbonate on the absorption of levothyroxine has not been studied systematically. Such a potential drug interaction merits investigation because concurrent treatment with both drugs is common, particularly in postmenopausal women. Objective To investigate the potential interference of calcium carbonate in the absorption of levothyroxine. Design Prospective cohort study conducted from November 1998 to June 1999, supplemented with an in vitro study of thyroxine (T-4) binding to calcium carbonate. Setting Veterans Affairs Medical Center in West Los Angeles, Calif. Patients Twenty patients (age range, 27-78 years; n=11 men) with hypothyroidism who were taking a stable long-term regimen of levothyroxine were included in the study. All patients had serum free T-4 and thyrotropin values in the normal range before beginning the study. Intervention Subjects were instructed to take 1200 mg/d of elemental calcium as calcium carbonate, ingested with their levothyroxine, for 3 months. Main Outcome Measures Levels of free T-4, total T-4, total triiodothyronine (T-3), and thyrotropin, measured in all subjects at baseline (while taking levothyroxine alone), at 2 and 3 months (while taking calcium carbonate and levothyroxine), and 2 months after calcium carbonate discontinuation (while continuing to take levothyroxine). Results Mean free T-4 and total T-4 levels were significantly reduced during the calcium period and increased after calcium discontinuation. Mean free T-4 levels were 17 pmol/L (1.3 ng/dL) at baseline, 15 pmol/L (1.2 ng/dL) during the calcium period, and 18 pmol/L (1.4 ng/dL) after calcium discontinuation (overall P<.001); mean total T-4 levels were 118 nmol/L (9.2 mu g/dL) at baseline, 111 nmol/L (8.6 mu g/dL) during the calcium period, and 120 nmol/L (9.3 mu g/dL) after calcium discontinuation (overall P=.03), Mean thyrotropin levels increased significantly, from 1.6 mIU/L at baseline to 2.7 mIU/L during the calcium period, and decreased to 1.4 mIU/L after calcium discontinuation (P=.008). Twenty percent of patients had serum thyrotropin levels higher than the normal range during the calcium period; the highest observed level was 7.8 mIU/L. Mean T-3 levels did not change du ring the calcium period. The in vitro study of T-4 binding to calcium showed that adsorption of T-4 to calcium carbonate occurs at acidic pH levels. Conclusions This study of 20 patients receiving long-term levothyroxine replacement therapy indicates that calcium carbonate reduces T-4 absorption and increases serum thyrotropin levels. Levothyroxine adsorbs to calcium carbonate in an acidic environment, which may reduce its bioavailability. C1 Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Healthcare Syst, Div Endocrinol & Metab, Los Angeles, CA 90073 USA. Loma Linda Med Ctr, Div Epidemiol, Loma Linda, CA USA. RP Singh, N (reprint author), Univ Calif Los Angeles, Sch Med, VA Greater Los Angeles Healthcare Syst, Div Endocrinol & Metab, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Singh, Pramil/C-5285-2012 NR 17 TC 76 Z9 79 U1 1 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 7 PY 2000 VL 283 IS 21 BP 2822 EP 2825 DI 10.1001/jama.283.21.2822 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 320BQ UT WOS:000087381500037 PM 10838651 ER PT J AU Katz, IR Coyne, JC AF Katz, IR Coyne, JC TI The public health model for mental health care for the elderly SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID DEPRESSION; INSTITUTIONALIZATION; DISEASE C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Family Practice, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Vet Integrated Serv Network Mental Illness Res Ed, Philadelphia, PA USA. RP Katz, IR (reprint author), Univ Penn, Dept Psychiat, 3600 Market St,Room 758, Philadelphia, PA 19104 USA. FU NIMH NIH HHS [MH P30MH52129] NR 15 TC 8 Z9 8 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 7 PY 2000 VL 283 IS 21 BP 2844 EP 2845 DI 10.1001/jama.283.21.2844 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 320BQ UT WOS:000087381500042 PM 10838656 ER PT J AU Hallen, S Fryklund, J Sachs, G AF Hallen, S Fryklund, J Sachs, G TI Inhibition of the human sodium/bile acid cotransporters by side-specific methanethiosulfonate sulfhydryl reagents: Substrate-controlled accessibility of site of inactivation SO BIOCHEMISTRY LA English DT Article ID CHANNEL-LINING RESIDUES; MEMBRANE-SPANNING SEGMENT; FUNCTIONAL EXPRESSION; TRANSPORT ACTIVITY; ILEAL; CLONING; NA+; IDENTIFICATION; RABBIT; VESICLES AB Mammalian sodium/bile acid cotransporters (SBATs) constitute a subgroup of the sodium cotransporter superfamily and function in the enterohepatic circulation of bile acids. They are glycoproteins with an exoplasmic N-terminus, seven or nine transmembrane segments, and a cytoplasmic C-terminus. They exhibit no significant homology with other members of the sodium cotransporter family and there is limited structure/function information available for the SBATs. Membrane-impermeant methanethiosulfonates (MTS) inhibited bile acid transport by alkylation of cysteine 270 (apical SBAT)/266 (basolateral SEAT) that is fully conserved among the sodium/bile acid cotransporters. The accessibility of this residue to MTS reagent is regulated by the natural substrates, sodium and bile acid. In experiments with the apical SEAT, sodium alone increases the reactivity with the thiol reagents as compared to sodium-free medium. In contrast, bile acids protect the SBATs from inactivation, although only in the presence of sodium, The inhibition and protection data suggest that cysteine 270/266 lies in a sodium-sensitive region of the SBATs that is implicated in bile acid transport. C1 Univ Calif Los Angeles, Los Angeles, CA 90073 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. AstraZeneca R&D, Cell Biol & Biochem, S-43183 Molndal, Sweden. RP Sachs, G (reprint author), W Los Angeles Vet Affairs Med Ctr, Membrane Biol Lab, 11301 Wilshire Blvd,Bldg 113,Rm 324, Los Angeles, CA 90073 USA. FU NIDDK NIH HHS [DK53462, DK46917] NR 26 TC 31 Z9 33 U1 0 U2 0 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0006-2960 J9 BIOCHEMISTRY-US JI Biochemistry PD JUN 6 PY 2000 VL 39 IS 22 BP 6743 EP 6750 DI 10.1021/bi000577t PG 8 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 323TF UT WOS:000087580500019 PM 10828993 ER PT J AU Morel, L Croker, BP Blenman, KR Mohan, C Huang, GL Gilkeson, G Wakeland, EK AF Morel, L Croker, BP Blenman, KR Mohan, C Huang, GL Gilkeson, G Wakeland, EK TI Genetic reconstitution of systemic lupus erythematosus immunopathology with polycongenic murine strains SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article ID ANTIGEN-PRESENTING CELLS; CONGENIC MOUSE STRAINS; SLE PATHOGENESIS; AUTOANTIBODY PRODUCTION; B-CELLS; DISSECTION; SUSCEPTIBILITY; CD86; MICE; EXPRESSION AB We previously produced three congenic strains carrying lupus susceptibility genes (Sle1-Sle3) from the lupus-prone NZM2410 mouse on the C57BL/6 background and characterized their component phenotypes, Sle1 mediates the loss of tolerance to nuclear antigens; Sle2 lowers the activation threshold of B cells; and Sle3 mediates a dysregulation of CD4(+) T cells. We have now created a collection of bi- and tricongenic strains with these intervals and assessed the autoimmune phenotypes they elicit in various combinations. Our results indicate that Sle1 is key for the development of fatal lupus, The combination of Sle1 with Sle2, Sle3, or the BXSB-derived autoimmune accelerating gene yaa results in the development of systemic autoimmunity with variably penetrant severe glomerulonephritis culminating in kidney failure. In contrast, two locus combinations of Sle2, Sle3, and yaa failed to mediate fatal disease. These results indicate that the loss of tolerance to chromatin mediated by Sle1 is essential for disease pathogenesis and identify the pathway occupied by Sle1 as a strategic target for therapeutic intervention in systemic lupus erythematosus. The coexpression of Sle1, Sle2, and Sle3 as a B6-triple congenic results in severe systemic autoimmunity and fully penetrant, fatal glomerulonephritis. These results demonstrate the fulfillment of the genetic equivalent of Koch's postulate, where susceptibility loci in a lupus-prone strain have been identified by a genome scan, isolated and functionally characterized by congenic dissection, and finally shown to mediate full disease expression when recombined in a normal genome. C1 Univ Texas, SW Med Ctr, Ctr Immunol, Dallas, TX 75235 USA. Univ Florida, Dept Pathol, Gainesville, FL 32610 USA. N Florida S George Vet Hlth Syst, Gainesville, FL 32608 USA. Ralph H Johnson Vet Affaris Med Coll, Med Res Serv, Charleston, SC 29425 USA. Med Univ S Carolina, Charleston, SC 29425 USA. Univ Florida, Dept Med, Gainesville, FL 32610 USA. RP Wakeland, EK (reprint author), Univ Texas, SW Med Ctr, Ctr Immunol, 5323 Harry Hines Blvd, Dallas, TX 75235 USA. FU NIAID NIH HHS [P01 AI039824, P01 AI39824]; NIAMS NIH HHS [R01 AR42563] NR 36 TC 248 Z9 251 U1 0 U2 2 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 USA SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD JUN 6 PY 2000 VL 97 IS 12 BP 6670 EP 6675 DI 10.1073/pnas.97.12.6670 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 322UA UT WOS:000087526300079 PM 10841565 ER PT J AU Natarajan, S Nietert, PJ Silverstein, MD AF Natarajan, S Nietert, PJ Silverstein, MD TI Variation by socioeconomic status in screening and prevalence of high cholesterol and hypertension. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Med Univ S Carolina, Ctr Hlth Care Res, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 2000 VL 151 IS 11 SU S MA 136 BP S34 EP S34 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 321MZ UT WOS:000087460400137 ER PT J AU Luck, J Peabody, JW Dresselhaus, TR Lee, M Glassman, P AF Luck, J Peabody, JW Dresselhaus, TR Lee, M Glassman, P TI How well does chart abstraction measure quality? A prospective comparison of standardized patients with the medical record SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID SIMULATED PATIENTS; GENERAL-PRACTITIONERS; VETERANS-AFFAIRS; HEALTH-CARE; PERFORMANCE AB PURPOSE: Despite widespread reliance on chart abstraction for quality measurement, concerns persist about its reliability and validity. We prospectively evaluated the validity of chart abstraction by directly comparing it with the gold standard of reports by standardized patients. SUBJECTS AND METHODS: Twenty randomly selected general internal medicine residents and attending faculty physicians at the primary care clinics of two Veterans Affairs Medical Centers blindly evaluated and treated actor-patients (standardized patients) who had one of four common diseases: diabetes, chronic obstructive pulmonary disease, coronary artery disease, or low back pain. Charts from the visits were abstracted using explicit quality criteria; standardized patients completed a checklist containing the same criteria. For each physician, quality was measured for two different cases of the four conditions (a total of 160 physician-patient encounters). We compared chart abstraction with standardized;patient reports for four aspects of the encounter: taking the history, examining the patient, making the diagnosis, and prescribing appropriate treat-ment. The sensitivity and specificity of chart abstraction were calculated. RESULTS: The mean (+/- SD) chart abstraction score was 54% +/- 9%, substantially less than the mean score on the standardized-patient checklist of 68% +/- 9% (P <0.001). This finding was similar for all four conditions and at both sites. "False positives"- chart-recorded necessary care actions not reported by the standardized patients-resulted in a specificity of only 81%. The overall sensitivity of chart abstraction for necessary care was only 70%. CONCLUSIONS: Chart abstraction underestimates the quality of care for common outpatient general medical conditions when compared with standardized-patient reports. The medical record is neither sensitive nor specific. Quality measurements derived from chart abstraction may have important shortcomings, particularly as the basis for drawing policy conclusions or making management decisions. (C) 2000 by Excerpta Medica, Inc. C1 Inst Global Hlth, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94105 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Vet Affairs Ctr Study Hlth Care Provider Behav, Sepulveda, CA USA. Univ Calif San Diego, Sch Med, San Diego, CA 92103 USA. San Diego Vet Affairs Med Ctr, San Diego, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. RAND, Santa Monica, CA USA. Inst Global Hlth, San Francisco, CA USA. RP Peabody, JW (reprint author), Inst Global Hlth, San Francisco Vet Affairs Med Ctr, 74 New Montgmery St,Suite 508, San Francisco, CA 94105 USA. RI Comba, Valentina/G-6210-2014 NR 52 TC 184 Z9 186 U1 1 U2 5 PU EXCERPTA MEDICA INC PI NEW YORK PA 245 WEST 17TH STREET, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD JUN 1 PY 2000 VL 108 IS 8 BP 642 EP 649 DI 10.1016/S0002-9343(00)00363-6 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 321QV UT WOS:000087466900006 PM 10856412 ER PT J AU Shaaban, AM Duerinckx, AJ AF Shaaban, AM Duerinckx, AJ TI Wall shear stress and early atherosclerosis: A review SO AMERICAN JOURNAL OF ROENTGENOLOGY LA English DT Review ID HUMAN CORONARY-ARTERIES; HUMAN ABDOMINAL-AORTA; ENDOTHELIAL-CELLS; IN-VIVO; BLOOD-FLOW; CAROTID BIFURCATION; DOPPLER ULTRASOUND; VELOCITY PROFILES; FLUID-SHEAR; HEMODYNAMICS C1 VA Greater Los Angeles Healthcare Ctr, Serv Radiol, Los Angeles, CA 90073 USA. RP Duerinckx, AJ (reprint author), VA N Texas Healthcare Syst, Serv Radiol, Mail Code 114, Dallas, TX 75216 USA. NR 47 TC 128 Z9 132 U1 1 U2 11 PU AMER ROENTGEN RAY SOC PI RESTON PA 1891 PRESTON WHITE DR, SUBSCRIPTION FULFILLMENT, RESTON, VA 22091 USA SN 0361-803X J9 AM J ROENTGENOL JI Am. J. Roentgenol. PD JUN PY 2000 VL 174 IS 6 BP 1657 EP 1665 PG 9 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 317EU UT WOS:000087213700035 PM 10845502 ER PT J AU Pettinati, HM Rukstalis, MR Luck, GJ Volpicelli, JR O'Brien, CP AF Pettinati, HM Rukstalis, MR Luck, GJ Volpicelli, JR O'Brien, CP TI Gender and psychiatric comorbidity: Impact on clinical presentation of alcohol dependence SO AMERICAN JOURNAL ON ADDICTIONS LA English DT Article ID WOMEN ALCOHOLICS; MENTAL-DISORDERS; DRINKING; DEPRESSION; ABUSE AB We examined differences in clinical presentation for outpatient alcohol treatment in: 1) males and females, considering comorbidity; and 2) three comorbid groups, considering gender. Drinking indices and emotional, physical, and sexual abuse reports were compared in 127 male and 69 female alcohol-dependent patients who have a current (36.2%) or lifetime (20.4%) psychiatric disorder or who never had a psychiatric disorder (43.4%). Females reported more emotional and physical abuse than males. Females reported drinking smaller volumes of alcohol but on more days than males. All with current comorbidity, irrespective of gender, reported more days of heavy drinking than other groups. When evaluating drinking status, gender and comorbidity should be considered. C1 Univ Penn, Dept Psychiat, Treatment Res Ctr, Ctr Study Addict, Philadelphia, PA 19104 USA. Philadelphia Med Ctr Vet Affairs, Philadelphia, PA USA. RP Pettinati, HM (reprint author), Univ Penn, Dept Psychiat, Treatment Res Ctr, Ctr Study Addict, 3900 Chestnut St, Philadelphia, PA 19104 USA. FU NIAAA NIH HHS [K08AA-00251, R01AA-07517, R01AA-09544] NR 29 TC 18 Z9 19 U1 1 U2 2 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1055-0496 J9 AM J ADDICTION JI Am. J. Addict. PD SUM PY 2000 VL 9 IS 3 BP 242 EP 252 PG 11 WC Substance Abuse SC Substance Abuse GA 354JT UT WOS:000089327900007 PM 11000920 ER PT J AU Lairmore, TC Chen, VY DeBenedetti, MK Gillanders, WE Norton, JA Doherty, GM AF Lairmore, TC Chen, VY DeBenedetti, MK Gillanders, WE Norton, JA Doherty, GM TI Duodenopancreatic resections in patients with multiple endocrine neoplasia type 1 SO ANNALS OF SURGERY LA English DT Article; Proceedings Paper CT 111th Annual Meeting of the Southern-Surgical-Association CY DEC 05-08, 1999 CL HOT SPRINGS, VIRGINIA SP SO Surg Assoc ID ISLET-CELL TUMORS; SELECTIVE INTRAARTERIAL INJECTION; GERMLINE MUTATIONS; MEN1 GENE; LOCALIZATION; PANCREAS; EXPERIENCE AB Objective To review the authors' 7-year experience with a surgical approach for pancreatic and duodenal neuroendocrine tumors (NETs) in patients with multiple endocrine neoplasia type 1 (MEN 1) designed to remove all gross tumor with limited complications, preserving pancreatic function. Summary Background Data MEN 1 is an autosomal dominant familial neoplasia syndrome characterized by the development of NETs of the duodenum and pancreas. Some tumors are clinically insignificant or follow a benign course, although a subset pursues a malignant, lethal natural history, the risk of surgical management must be appropriate to the disease course. Methods The clinical, biochemical, genetic, and pathologic data were retrospectively reviewed for 21 consecutive MEN 1 patients undergoing pancreatic resection for NETs between 1993 and 1999 at one institution. Age at operation, presenting symptoms, results of preoperative and intraoperative localization studies, major and minor complications, and pathology, including metastases, were analyzed. Results The surgical approach was selected based on the location and size of the tumors. Five patients required pancreaticoduodenectomy, 11 patients underwent non-Whipple pancreatic resections, and 5 underwent simple enucleation of benign NETs. The incidence of regional lymph node metastases was 33%. Conclusions Major pancreatic procedures can be performed safely in most patients with MEN 1 and NETs. Because NETs are the most common MEN I-related cause of death in the authors' kindreds, an aggressive surgical approach, including early intervention before malignant spread and major pancreatic resection where indicated, appears justified. C1 Washington Univ, Sch Med, Sect Endocrine & Oncol Surg, Dept Surg, St Louis, MO 63110 USA. San Francisco VA Med Ctr, Surg Serv, San Francisco, CA USA. RP Lairmore, TC (reprint author), Washington Univ, Sch Med, Sect Endocrine & Oncol Surg, Dept Surg, Box 8109,660 S Euclid Ave, St Louis, MO 63110 USA. FU NCRR NIH HHS [M01RR00036, M01 RR000036] NR 25 TC 55 Z9 58 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-4932 J9 ANN SURG JI Ann. Surg. PD JUN PY 2000 VL 231 IS 6 BP 909 EP 916 DI 10.1097/00000658-200006000-00016 PG 8 WC Surgery SC Surgery GA 321UF UT WOS:000087472500031 PM 10816635 ER PT J AU Matzke, GR Frye, RF Joy, MS Palevsky, PM AF Matzke, GR Frye, RF Joy, MS Palevsky, PM TI Determinants of ceftazidime clearance by continuous venovenous hemofiltration and continuous venovenous hemodialysis SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID RENAL REPLACEMENT THERAPY; ANTIMICROBIAL ACTIVITY; MEDICAL-CENTERS; PHARMACOKINETICS; ADJUSTMENTS; ANTIBIOTICS; MEMBRANES AB Although several dosage adjustment regimens have been proposed, there is little quantitative information to guide the initiation of ceftazidime therapy in patients who are receiving continuous renal replacement therapy. To determine the clearance of ceftazidime by continuous venovenous hemofiltration (CVVH) and continuous venovenous hemodialysis (CVVHD), we performed controlled clearance studies with stable hemodialysis patients with three hemofilters: a 0.6-m(2) acrylonitrile copolymer (AN69; Hospal) filter, a 2.1-m(2) polymethylmethacrylate filter (PMMA; Toray) filter and a 0.65-m(2) polysulfone (PS; Fresenius) filter. Subjects received 1,000 mg of ceftazidime intravenously prior to the start of a clearance study. The concentration of ceftazidime in multiple plasma and dialysate or ultrafiltrate samples was determined by high-performance liquid chromatography. The diffusional clearances (CIdiffusion) and sieving coefficients of ceftazidime were compared by a mixed-model repeated-measures analysis of variance with filter and blood, dialysate inflow, or ultrafiltration rate as the main effect and the patient as a random effect. The fraction of ceftazidime bound to plasma proteins was 17% +/- 7% (range, 10 to 25%). The clearances of ceftazidime, urea, and creatinine by CVVHD were essentially constant at blood how rates of 75 to 250 ml/min for all three filters. Significant linear relationships (P < 0.0001) were observed between CIdiffusion of ceftazidime and clearance of urea for all three filters: AN69 (slope = 0.83), PMMA (slope = 0.89), and PS (slope = 1.03). Ceftazidime clearance was membrane independent during CVVH and CVVHD. CVVH and CVVHD can significantly augment the clearance of ceftazidime. Dosing strategies for initiation of ceftazidime therapy in patients receiving CVVH and CVVHD are proposed. C1 Univ Pittsburgh, Sch Pharm, Ctr Clin Pharmacol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA 15261 USA. VA Pittsburgh Hlth Care Syst, Renal Sect, Pittsburgh, PA USA. Univ N Carolina, Sch Med, Div Nephrol & Hypertens, Chapel Hill, NC USA. RP Matzke, GR (reprint author), Univ Pittsburgh, Sch Pharm, Ctr Clin Pharmacol, 724 Salk Hall, Pittsburgh, PA 15261 USA. OI Palevsky, Paul/0000-0002-7334-5400; Frye, Reginald/0000-0002-1841-1401 FU NCRR NIH HHS [5M01 RR00056, M01 RR000056] NR 27 TC 20 Z9 21 U1 1 U2 2 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD JUN PY 2000 VL 44 IS 6 BP 1639 EP 1644 DI 10.1128/AAC.44.6.1639-1644.2000 PG 6 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 316FC UT WOS:000087156100036 PM 10817721 ER PT J AU Means, RT AF Means, RT TI The anaemia of infection SO BEST PRACTICE & RESEARCH CLINICAL HAEMATOLOGY LA English DT Article DE anaemia; infection; cytokines; ferrokinetics; erythropoietin; iron; host defence ID TUMOR-NECROSIS-FACTOR; COLONY-FORMING-UNITS; RECOMBINANT-HUMAN-ERYTHROPOIETIN; PLASMODIUM-FALCIPARUM MALARIA; RHEUMATOID-ARTHRITIS; FACTOR-ALPHA; HEMOLYTIC-ANEMIA; CHRONIC DISEASE; TRANSFERRIN RECEPTORS; INTERFERON-GAMMA AB Anaemia is a common finding in infected individuals, and in many cases is an indicator of disease activity and/or duration. The term 'anaemia of infection' refers to a specific syndrome related to the more broadly defined 'anaemia of chronic disease', in this syndrome, cytokines produced as part of the host response to infection induce anaemia by well-defined pathophysiological mechanisms. In this chapter, the diagnosis, significance, pathophysiology and treatment of the anaemia of infection will be reviewed. Other mechanisms which can produce anaemia in infected individuals will also be reviewed. C1 Med Univ S Carolina, Div Hematol Oncol, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Hematol Oncol Sect, Charleston, SC USA. RP Means, RT (reprint author), Med Univ S Carolina, Div Hematol Oncol, 903 CSB,96 Jonathan Lucas St,POB 250623, Charleston, SC 29425 USA. RI Means, Robert/A-4454-2008 FU NHLBI NIH HHS [HL53703] NR 98 TC 54 Z9 56 U1 0 U2 0 PU BAILLIERE TINDALL PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1521-6926 J9 BEST PRACT RES CL HA JI Best Pract. Res. Clin. Haematol. PD JUN PY 2000 VL 13 IS 2 BP 151 EP 162 DI 10.1053/beha.1999.0065 PG 12 WC Hematology SC Hematology GA 344NA UT WOS:000088764700002 PM 10942618 ER PT J AU Schumacher, HR AF Schumacher, HR TI Haemochromatosis SO BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY LA English DT Article DE iron; cartilage; metacarpophalangeal joint; chrondrocalcinosis; calcium pyrophosphate dihydrate (CPPD) ID IDIOPATHIC HEMOCHROMATOSIS; IRON OVERLOAD; GENETIC HEMOCHROMATOSIS; ARTHROPATHY; ARTHRITIS; FEATURES; BONE AB Arthropathy is a prominent but still underappreciated aspect of haemochromatosis. Clinical descriptions have characterized typical features, including involvement of the 2nd-3rd metacarpophalangeal joints with an osteoarthritic-like picture. Virtually any joint can be involved and can be a presenting clue to the underlying disease. The recent demonstration of the HFE gene on chromosome 6 with characteristic mutations should encourage further investigation. However, the pathogenesis of the arthropathy is not yet well understood. Treatment is also empirical and often unsatisfactory. Phlebotomies, although valuable to treat or prevent other features, do not predictably benefit the arthropathy. C1 Univ Penn, Sch Med, Div Rheumatol, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Rheumatol Immunol Ctr, Philadelphia, PA 19104 USA. RP Schumacher, HR (reprint author), Univ Penn, Sch Med, Div Rheumatol, Philadelphia, PA 19104 USA. NR 35 TC 8 Z9 8 U1 0 U2 1 PU BAILLIERE TINDALL PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1521-6942 J9 BEST PRACT RES CL RH JI Best Pract. Res. Clin. Rheumatol. PD JUN PY 2000 VL 14 IS 2 BP 277 EP 284 DI 10.1053/berh.2000.0065 PG 8 WC Rheumatology SC Rheumatology GA 336BV UT WOS:000088282800006 PM 10925745 ER PT J AU Mahomed, K Williams, MA Woelk, GB Mudzamiri, S Madzime, S King, IB Bankson, DD AF Mahomed, K Williams, MA Woelk, GB Mudzamiri, S Madzime, S King, IB Bankson, DD TI Leukocyte selenium, zinc, and copper concentrations in preeclamptic and normotensive pregnant women SO BIOLOGICAL TRACE ELEMENT RESEARCH LA English DT Article DE preeclampsia; pregnancy; trace elements; selenium; zinc; copper ID GLUTATHIONE-PEROXIDASE ACTIVITY; INDUCED HYPERTENSION; PLASMA; SUPPLEMENTATION; MAGNESIUM; GESTOSIS; CALCIUM; BLOOD AB Preeclampsia is an important cause of maternal and perinatal mortality worldwide. The etiology of this relatively common medical complication of pregnancy, however, remains unknown. We studied the relationship between maternal leukocyte selenium, zinc, and copper concentrations and the risk of preeclampsia in a large hospital-based case-control study. One hundred seventy-one women with proteinuric pregnancy-induced hypertension (with or without seizures) comprised the case group. Controls were 184 normotensive pregnant women. Leukocytes were separated from blood samples collected during the patients' postpartum labor and delivery admission. Leukocyte concentrations for the three cations were measured by inductively coupled plasma-mass spectrometry (ICP-MS). Concentrations for each cation were reported as micrograms per gram of total protein. Women with preeclampsia had significantly higher median leukocyte selenium concentrations than normotensive controls (3.23 vs 2.80 mu g/g total protein, p < 0.0001). Median leukocyte zinc concentrations were 31% higher in preeclamptics as compared with controls (179.15 vs 136.44 mu g/g total protein, p < 0.0001). Although median leukocyte copper concentrations were slightly higher for cases than controls, this difference did not reach statistical significance (17.72 vs 17.00 mu g/g total protein, p = 0.468). There was evidence of a linear increase in risk of preeclampsia with increasing concentrations of selenium and zinc. The relative risk for preeclampsia was 3.38 (adjusted odds ratio [OR] = 3.38, 95% confidence interval [CI] = 1.53-7.54) among women in the highest quartile of the control selenium distribution compared with women in the lowest quartile. The corresponding relative risk and 95% CI for preeclampsia was 5.30 (2.45-11.44) for women in the highest quartile of the control zinc distribution compared with women in the lowest quartile. There was no clear pattern of a linear trend in risk with increasing concentration of leukocyte copper concentrations (adjusted for Linear trend in risk = 0.299). Our results are consistent with some previous reports. Prospective studies are needed to determine whether observed alterations in selenium and zinc concentrations precede preeclampsia or whether the differences may be attributed to preeclampsia-related alterations in maternal and fetal-placental trace metal metabolism. C1 Univ Zimbabwe, Sch Med, Dept Obstet & Gynecol, Harare, Zimbabwe. Univ Zimbabwe, Sch Med, Dept Community Med, Harare, Zimbabwe. Univ Washington, Sch Publ Hlth & Community Med, Dept Epidemiol, Seattle, WA 98195 USA. Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Seattle, WA 98104 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Mahomed, K (reprint author), Univ Zimbabwe, Sch Med, Dept Obstet & Gynecol, Harare, Zimbabwe. RI Mahomed, Kassam/M-1335-2013 FU FIC NIH HHS [T37-TW00049]; NICHD NIH HHS [HD/HL R01-32562] NR 25 TC 35 Z9 36 U1 0 U2 2 PU HUMANA PRESS INC PI TOTOWA PA 999 RIVERVIEW DRIVE SUITE 208, TOTOWA, NJ 07512 USA SN 0163-4984 J9 BIOL TRACE ELEM RES JI Biol. Trace Elem. Res. PD SUM PY 2000 VL 75 IS 1-3 BP 107 EP 118 DI 10.1385/BTER:75:1-3:107 PG 12 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 333JX UT WOS:000088128100011 PM 11051601 ER PT J AU Bartzokis, G Tishler, TA AF Bartzokis, G Tishler, TA TI MRI evaluation of basal ganglia ferritin iron and neurotoxicity in Alzheimer's and Huntingon's disease SO CELLULAR AND MOLECULAR BIOLOGY LA English DT Review DE Alzheimer's disease; Huntington's disease; magnetic resonance; ferritin; iron; basal ganglia; FDRI; relaxation; field-dependent ID AMYLOID PRECURSOR PROTEIN; DIFFERENT FIELD STRENGTHS; BRAIN IRON; MAGNETIC-RESONANCE; OXIDATIVE DAMAGE; FREE-RADICALS; PARKINSONS-DISEASE; METAL-IONS; IN-VITRO; NEUROFIBRILLARY TANGLES AB Background: The basal ganglia contain the highest levels of iron in the brain and post-mortem studies indicate a disruption of iron metabolism in the basal ganglia of patients with neurodegenerative disorders such as Alzheimer's disease (AD) and Huntington's disease (HD). Iron can catalyze free radical reactions and may contribute to oxidative damage observed in ND and HD brain. Magnetic resonance imaging (MRI) can quantify transverse relaxation rates, which can be used to quantify tissue iron stores as well as evaluate increases in MR-visible water tan indicator of tissue damage). Methods: A magnetic resonance imaging (MRI) method termed the field dependent relaxation rate increase (FDRI) was employed which quantifies the iron content of ferritin molecules (ferritin iron) with specificity through the combined use of high and low field-strength MRI instruments. Three basal ganglia structures (caudate, putamen and globus pallidus) and one comparison region (frontal lobe white matter) were evaluated. Thirty-one patients with AD and a group of 68 older control subjects, and 11 patients with HD and a group of 27 adult controls participated (4 subjects overlap between AD and HD controls). Results: Compared to their respective normal control groups, increases in basal ganglia FDRI levels were seen in both AD and HD. FDRI levels were significantly increased in the caudate (p = 0.007) and putamen (p = 0.008) of patients with AD with a trend toward an increase in the globus pallidus (p = 0.13). In the patients with HD, all three basal ganglia regions showed highly significant FDRI increases (p<0.001) and the magnitude of the increases were 2 to 3 times larger than those observed in AD versus control group comparison. For both HD and AD subjects, the basal ganglia FDRI increase was not a generalized phenomenon, as frontal lobe white matter FDRI levels were decreased in HD (p = 0.015) and remained unchanged in AD. Significant low field relaxation rate decreases (suggestive of increased MR-visible water and indicative of tissue damage) were seen in the frontal lobe white matter of both HD and AD but only the HD basal ganglia showed such decreases. Conclusions: The data suggest that basal ganglia ferritin iron is increased in HD and PLD. Furthermore, the increased iron levels do not appear to be a byproduct of the illness itself since they seem to be present at the onset of the diseases, and thus may be considered a putative risk factor. Published post-mortem studies suggest that the increase in basal ganglia ferritin iron may occur through different mechanisms in HD and AD. Consistent with the known severe basal ganglia damage, only HD basal ganglia demonstrated significant decreases in low field relaxation rates. MRI can be used to dissect differences in tissue characteristics, such as ferritin iron and MR-visible water, and thus could help clarify neuropathologic processes in vivo. Interventions aimed at decreasing brain iron levels, as well as reducing the oxidative stress associated with increased iron levels, may offer novel ways to delay the rate of progression and possibly defer the onset of AD and HD. C1 Univ Arkansas Med Sci, Dept Psychiat, Little Rock, AR 72205 USA. Cent Arkansas Vet Healthcare Syst, Mental Hlth Serv, Little Rock, AR 72214 USA. VA Greater Los Angeles Healthcare Syst, Mental Hlth Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Interdepartmental Program Neurosci, Los Angeles, CA 90024 USA. RP Bartzokis, G (reprint author), N Little Rock VA Med Ctr 116A, NLR, 2200 Ft Roots Dr,Bldg 170, N Little Rock, AR 72114 USA. RI Bartzokis, George/K-2409-2013 NR 102 TC 128 Z9 135 U1 4 U2 15 PU CELLULAR & MOLECULAR BIOLOGY PI NOISY-LE-GRAND PA PROF R WEGMANN RESIDENCE HAUSSMANN 1 AVENUE DU PAVE NEUF, 93160 NOISY-LE-GRAND, FRANCE SN 0145-5680 J9 CELL MOL BIOL JI Cell. Mol. Biol. PD JUN PY 2000 VL 46 IS 4 BP 821 EP 833 PG 13 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 324QW UT WOS:000087633700012 PM 10875443 ER PT J AU Dinovo, EC Renner, SW Rubin, SA Mody, FV AF Dinovo, EC Renner, SW Rubin, SA Mody, FV TI Discordant Troponin T results with the CardiacT as a function of total CK activity. SO CLINICAL CHEMISTRY LA English DT Meeting Abstract C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC CLINICAL CHEMISTRY PI WASHINGTON PA 2101 L STREET NW, SUITE 202, WASHINGTON, DC 20037-1526 USA SN 0009-9147 J9 CLIN CHEM JI Clin. Chem. PD JUN PY 2000 VL 46 IS 6 SU S MA 349 BP A91 EP A91 PN 2 PG 1 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 326GU UT WOS:000087725600351 ER PT J AU George, MS AF George, Mark S. TI New Methods of Brain Stimulation Are Improving Research and Therapy in Obsessive-Compulsive Disorder SO CNS SPECTRUMS LA English DT Article AB Over the past decade, new functional neuroimaging tools have enabled researchers to identify the specific brain regions involved in obsessive-compulsive disorder (OCD). More recently, researchers have perfected several new techniques for stimulating the brain. With some exception's, these new brain stimulation techniques are regionally specific and less invasive than older methods. As a class, these "somatic interventions" build on prior neuroanatomic information about OCD. This article reviews the past and current status of these brain stimulation methodologies, which promise to revolutionize neuropsychiatric research and therapy over the next 10 to 20 years. As the brain circuits in. OCD and the pharmacology within those circuits become better understood, these brain stimulation techniques hold particular promise in. helping to understand and perhaps treat OCD. CNS Spectrums 2000;5(6)suppl 4:12-17 C1 [George, Mark S.] Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. [George, Mark S.] Ralph H Johnson Vet Hosp, Charleston, SC USA. [George, Mark S.] MUSC Funct Neuroimaging Res Div, Charleston, SC USA. RP George, MS (reprint author), Med Univ S Carolina, Dept Radiol, 171 Ashley Ave, Charleston, SC 29425 USA. NR 39 TC 5 Z9 5 U1 0 U2 0 PU M B L COMMUNICATIONS, INC PI NEW YORK PA 333 HUDSON ST, 7TH FLOOR, NEW YORK, NY 10013 USA SN 1092-8529 J9 CNS SPECTRUMS JI CNS Spectr. PD JUN PY 2000 VL 5 IS 6 BP 12 EP 17 PG 6 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA V04RD UT WOS:000207074600002 ER PT J AU Buergler, JM Tio, FO Schulz, DG Khan, MM Mazur, W French, BA Raizner, AE Ali, NM AF Buergler, JM Tio, FO Schulz, DG Khan, MM Mazur, W French, BA Raizner, AE Ali, NM TI Use of nitric-oxide-eluting polymer-coated coronary stents for prevention of restenosis in pigs SO CORONARY ARTERY DISEASE LA English DT Article DE nitric oxide; angioplasty; animal model ID CONTROLLED BIOLOGICAL RELEASE; VASCULAR SMOOTH-MUSCLE; BALLOON ANGIOPLASTY; NUCLEOPHILE COMPLEXES; RELAXING FACTOR; ARTERY DISEASE; NO DONOR; ENDOTHELIUM; PROLIFERATION; AGENTS AB Background Restenosis after angioplasty remains an unresolved problem despite an increase in use of coronary stents. It has been theorized that nitric oxide (NO) exerts several actions that can prevent restenosis. These include inhibition of proliferation of smooth muscle cells, prevention of arterial spasms, and decreasing aggregation of platelets in response to exposure to collagen. Objective To determine whether NO coated stents decrease restenosis in a pig balloon injury model. Methods We used coronary stents impregnated with a slow-release precursor of NO in the porcine model of restenosis. Tantalum coil coronary stents (Cordis) were coated with a polymer impregnated with a slow-release precursor of NO. Polymer-coated stents without active precursors were used as controls. Oversized stents were mounted on a delivery balloon and subsequently deployed in the right coronary and left anterior descending arteries of each animal. Results Repeated recording of angiograms demonstrated that changes in minimum lumen diameter on going iron? immediately after stenting to 28-day follow-up for the control and NO-eluting-stent groups were similar, namely decreases of 1.89 +/- 0.33 and 2.08 +/- 0.28 mm, respectively The morphometric results, showing that severe luminal narrowing occurred for both groups, were similar The percentage area stenoses were 85 +/- 5% for the control group and 84 +/- 6% for the NO-eluting group. Histology demonstrated that profuse formation of neointima and an inflammatory cell infiltrate occurred. Conclusions Severe diameter stenosis occurred both for control and for treatment groups. The degree of angiographic stenosis was markedly worse than that previously reported for this model. Sustained release of a precursor of NO did not prevent restenosis in this model. This might have been due to a lack of efficacy of nitric oxide or to a profuse and overwhelming stimulatory effect of the polymer in the coated stents. Coron Artery Dis 11:351-357 (C) 2000 Lippincott Williams & Wilkins. C1 Baylor Coll Med, Dept Med, Cardiol Sect, VA Med Ctr, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. Univ Texas, Dept Pathol, San Antonio, TX 78285 USA. RP Ali, NM (reprint author), Baylor Coll Med, Dept Med, Cardiol Sect, VA Med Ctr, Mail Stn 111B,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 37 TC 17 Z9 23 U1 1 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0954-6928 J9 CORONARY ARTERY DIS JI Coronary Artery Dis. PD JUN PY 2000 VL 11 IS 4 BP 351 EP 357 DI 10.1097/00019501-200006000-00009 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 321HX UT WOS:000087451000009 PM 10860179 ER PT J AU Behroozan, DS Christian, MM Moy, RL AF Behroozan, DS Christian, MM Moy, RL TI Mycobacterium fortuitum infection following neck liposuction: A case report SO DERMATOLOGIC SURGERY LA English DT Article C1 Univ Calif Los Angeles, W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA USA. RP Moy, RL (reprint author), 100 UCLA Med Plaza,Suite 590, Los Angeles, CA 90024 USA. NR 12 TC 19 Z9 20 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 1076-0512 J9 DERMATOL SURG JI Dermatol. Surg. PD JUN PY 2000 VL 26 IS 6 BP 588 EP 590 DI 10.1046/j.1524-4725.2000.99165.x PG 3 WC Dermatology; Surgery SC Dermatology; Surgery GA 320KX UT WOS:000087401300020 PM 10848943 ER PT J AU Mironova, MA Klein, RL Virella, GT Lopes-Virella, MF AF Mironova, MA Klein, RL Virella, GT Lopes-Virella, MF TI Anti-modified LDL antibodies, LDL-containing immune complexes, and susceptibility of LDL to in vitro oxidation in patients with type 2 diabetes SO DIABETES LA English DT Article ID LOW-DENSITY-LIPOPROTEIN; MONOCYTE-DERIVED MACROPHAGES; CHOLESTERYL ESTER SYNTHESIS; CORONARY-ARTERY DISEASE; FATTY-ACID COMPOSITION; OXIDIZED LDL; MUSCLE TRIGLYCERIDE; RADICAL GENERATION; LIPID-PEROXIDATION; METABOLIC CONTROL AB We investigated the hypothesis that modified lipoproteins trigger an immune response leading to the production of autoantibodies and subsequently to the formation of atherogenic immune complexes (IC). We recruited 20 type 2 diabetic patients with macrovascular disease, 14 nondiabetic patients with coronary artery disease (CAD), and 34 healthy control subjects matched for age, sex, and race. Serum antibodies to oxidized and glycated LDL did not differ significantly among the 3 groups. Serum IC contained variable, but not statistically different, amounts of IgG, IgM, and IgA. In contrast, the content of cholesterol in IC isolated from diabetic patients was significantly higher than that in IC isolated from control subjects, and the content of apolipoprotein (apo)-B was significantly higher than that in IC isolated from control subjects and patients with CAD. Cholesteryl ester accumulation in human monocyte-derived macrophages incubated with IC, a measure of the atherogenic potential of IC, was significantly higher in macrophages incubated with red blood cell-adsorbed IC isolated from diabetic patients compared with IC isolated from control subjects (P < 0.03) or from patients with CAD (P < 0.04) and was strongly correlated with the content of apoB (r = 0.68, P < 0.001) and cholesterol(r = 0.61, P < 0.001) in IC. LDL from diabetic patients was more susceptible to oxidation in vitro, was significantly smaller, and contained significantly less or-tocopherol than LDL isolated from subjects in the other groups. In addition, the n-3 polyunsaturated fatty acid content of phospholipids and cholesteryl. esters in LDL isolated from diabetic patients was significantly increased (P < 0.05) compared with that from patients with CAD or from control subjects. me postulate that LDL size, susceptibility to oxidation, and Lipid fatty acid composition may play a critical role in the production of antibodies to oxidized LDL and consequently in the formation of LDL-containing IC in patients with type 2 diabetes. C1 Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC 29403 USA. Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. Med Univ S Carolina, Div Endocrinol Metab & Med Genet, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Lopes-Virella, MF (reprint author), Ralph H Johnson Dept Vet Affairs Med Ctr, Strom Thirmond Bldg,Rm 529,109 Bee St, Charleston, SC 29403 USA. NR 50 TC 43 Z9 45 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0012-1797 J9 DIABETES JI Diabetes PD JUN PY 2000 VL 49 IS 6 BP 1033 EP 1041 DI 10.2337/diabetes.49.6.1033 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 318ZG UT WOS:000087314100020 PM 10866057 ER PT J AU Wu, AW Gifford, A Asch, S Cohn, SE Bozzette, SA Yurk, R AF Wu, AW Gifford, A Asch, S Cohn, SE Bozzette, SA Yurk, R TI Quality-of-care indicators for HIV/AIDS SO DISEASE MANAGEMENT & HEALTH OUTCOMES LA English DT Review ID HUMAN-IMMUNODEFICIENCY-VIRUS; NATIONAL PROBABILITY SAMPLES; LOW-PREVALENCE DISEASES; HIV-INFECTED VETERANS; MEDICAL OUTCOMES; SERVICES UTILIZATION; UNITED-STATES; HEALTH SURVEY; PREDICTING OUTCOMES; CLINICAL PREDICTORS AB As care for HIV/AIDS becomes more concentrated within specific providers and organisations, it would be useful to have indicators to describe the quality of care. This paper reviews concepts related to quality of care, and practical issues including sampling and risk adjustment. Indicators can be collected using a combination of administrative, chart review and survey data to reflect clinical, patient and societal perspectives. We suggest that for adults with HIV/AIDS, indicators might include measures of health status and patient satisfaction, and essential care processes. Health status measures could include CD4+ T-lymphocyte count and HIV-RNA, progression to AIDS. symptom scores, health-related quality of life scores. patient utility and disability days. Essential care processes could include receipt of acceptable antiretroviral treatment, CD4+ and HIV-RNA monitoring, screening for opportunistic infections, prophylaxis against Pneumocystis carinii pneumonia, handling of symptoms and pneumococcal vaccination. For those at increased risk for HIV, potential indicators include screening for HIV risk behaviours and HIV testing. Data from indicators such as these could be used by individuals to select among providers, purchasers of carl to select among health plans and payers to hold provider groups accountable. In addition, data could be used by groups of providers to improve the quality of care. C1 Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD USA. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, Baltimore, MD USA. Univ Calif San Diego, San Diego, CA 92103 USA. RAND Corp, Santa Monica, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Univ Rochester, Med Ctr, Rochester, NY 14642 USA. Fdn Accountabil, Portland, OR USA. RP Wu, AW (reprint author), Hlth Serv Res & Dev Ctr, 624 N Broadway, Baltimore, MD 21205 USA. NR 85 TC 7 Z9 7 U1 3 U2 3 PU ADIS INTERNATIONAL LTD PI AUCKLAND PA 41 CENTORIAN DR, PRIVATE BAG 65901, MAIRANGI BAY, AUCKLAND 10, NEW ZEALAND SN 1173-8790 J9 DIS MANAG HEALTH OUT JI Dis. Manag. Health Outcomes PD JUN PY 2000 VL 7 IS 6 BP 315 EP 330 DI 10.2165/00115677-200007060-00003 PG 16 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 329GK UT WOS:000087898700003 ER PT J AU Kovacs, TO Jensen, DM AF Kovacs, TO Jensen, DM TI Endoscopic treatment of acute esophageal variceal bleeding SO DRUGS OF TODAY LA English DT Review ID PROSPECTIVE RANDOMIZED TRIAL; CONTROLLED CLINICAL-TRIAL; INJECTION SCLEROTHERAPY; PORTAL-HYPERTENSION; COMPARING SOMATOSTATIN; CIRRHOTIC-PATIENTS; BALLOON TAMPONADE; PORTACAVAL-SHUNT; ORAL PROPRANOLOL; REBLEEDING RATE AB Improvements in pharmacologic and endoscopic therapy have greatly benefited patients with portal hypertension and acute UGI hemorrhage. The advent of endoscopic band ligation has provided a valuable therapeutic option. Sclerotherapy remains an important treatment alternative, especially in the setting of active bleeding and in cases of small varices that cannot be adequately treated with band ligation. Long-term prevention of variceal hemorrhage is possible only if obliteration is maintained. Regular endoscopic surveillance and retreatment are critical since varices may recur regardless of which endoscopic method is used for treatment (C) 2000 Prous Science. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Los Angeles, CA 90073 USA. RP Kovacs, TO (reprint author), VA Greater Los Angeles Healthcare Syst, CURE Digest Dis Res Ctr, Bldg 115,Room 211,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. NR 87 TC 0 Z9 0 U1 0 U2 0 PU PROUS SCIENCE, SA PI BARCELONA PA PO BOX 540, PROVENZA 388, 08025 BARCELONA, SPAIN SN 0025-7656 J9 DRUGS TODAY JI Drugs Today PD JUN PY 2000 VL 36 IS 6 BP 339 EP 353 PG 15 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 333DH UT WOS:000088113100001 PM 12861356 ER PT J AU McHorney, CA Bricker, DE Kramer, AE Rosenbek, JC Robbins, J Chignell, KA Logemann, JA Clarke, C AF McHorney, CA Bricker, DE Kramer, AE Rosenbek, JC Robbins, J Chignell, KA Logemann, JA Clarke, C TI The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: I. Conceptual foundation and item development SO DYSPHAGIA LA English DT Article DE health outcomes; quality of life; patient satisfaction; quality of care; outcomes measurement; deglutition; deglutition disorders ID QUALITY-OF-LIFE; NECK-CANCER-PATIENTS; HEALTH-STATUS SCALES; CLINICAL-TRIALS; MALIGNANT DYSPHAGIA; ESOPHAGEAL CANCER; LASER THERAPY; ENDOSCOPIC INTUBATION; FUNCTIONAL STATUS; HEART-FAILURE AB In the past two decades, noteworthy advances have been made in measuring the physiologic outcomes of dysphagia, including measurement of duration of structure and bolus movements, stasis, and penetration-aspiration. However, there is a paucity of data on health outcomes from the patients' perspective, such as quality of life and patient satisfaction. A patient-based, dysphagia-specific outcomes tool is needed to enhance information on treatment variations and treatment effectiveness. We present the conceptual foundation and item generation process for the SWAL-QOL, a quality of life and quality of care outcomes tool under development for dysphagia researchers and clinicians. C1 Univ Kentucky, Med Ctr, Ctr Hlth Serv Res & Management, Lexington, KY 40536 USA. Lexington VA Med Ctr, HSR&D Program, Lexington, KY USA. Marquette Univ, Coll Profess Studies, Milwaukee, WI 53233 USA. Univ Wisconsin, Dept Surg, Madison, WI USA. William S Middleton Mem Vet Hosp, Madison, WI USA. Univ Wisconsin, Sch Med, Madison, WI USA. Northwestern Univ, Dept Commun Sci & Disorders, Chicago, IL 60611 USA. Northwestern Univ, Dept Otolaryngol & Neurol, Chicago, IL 60611 USA. RP McHorney, CA (reprint author), Univ Kentucky, Med Ctr, Ctr Hlth Serv Res & Management, 121 Washington Ave, Lexington, KY 40536 USA. NR 81 TC 92 Z9 113 U1 0 U2 6 PU SPRINGER VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0179-051X J9 DYSPHAGIA JI Dysphagia PD SUM PY 2000 VL 15 IS 3 BP 115 EP 121 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 324TF UT WOS:000087636900001 PM 10839823 ER PT J AU McHorney, CA Bricker, DE Robbins, J Kramer, AE Rosenbek, JC Chignell, KA AF McHorney, CA Bricker, DE Robbins, J Kramer, AE Rosenbek, JC Chignell, KA TI The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: II. Item reduction and preliminary scaling SO DYSPHAGIA LA English DT Article DE quality of life; patient satisfaction; quality of care; outcomes measurement; psychometrics; deglutition; deglutition disorders ID QUALITY-OF-LIFE; HEALTH-STATUS; CARE; SF-36; QUESTIONNAIRES; SATISFACTION; DISEASE AB The SWAL-QOL outcomes tool was constructed for use in clinical research for patients with oropharyngeal dysphagia. The SWAL-QOL was constructed a priori to enable preliminary psychometric analyses of items and scales before its final validation. This article describes data analysis from a pretest of the SWAL-QOL. We evaluated the different domains of the SWAL-QOL for respondent burden, data quality, item variability, item convergent validity, internal consistency reliability as measured by Cronbach's alpha, and range and skewness of scale scores upon aggregation and floor and ceiling effects. The item reduction techniques outlined reduced the SWAL-QOL from 185 to 93 items. The pretest of the SWAL-QOL afforded us the opportunity to select items for the ongoing validation study which optimally met our a priori psychometric criteria of high data quality, normal item distributions, and robust evidence of item convergent validity. C1 Univ Kentucky, Med Ctr, Ctr Hlth Serv Res & Management, Lexington, KY 40536 USA. Lexington VA Med Ctr, HSR&D Program, Lexington, KY USA. Marquette Univ, Coll Professional Studies, Milwaukee, WI 53233 USA. Univ Wisconsin, Sch Med, Madison, WI USA. Univ Wisconsin, Dept Surg, Madison, WI USA. William S Middleton Mem Vet Hosp, Madison, WI USA. RP McHorney, CA (reprint author), Univ Kentucky, Med Ctr, Ctr Hlth Serv Res & Management, 121 Washington Ave, Lexington, KY 40536 USA. NR 28 TC 78 Z9 92 U1 1 U2 5 PU SPRINGER VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0179-051X J9 DYSPHAGIA JI Dysphagia PD SUM PY 2000 VL 15 IS 3 BP 122 EP 133 PG 12 WC Otorhinolaryngology SC Otorhinolaryngology GA 324TF UT WOS:000087636900002 PM 10839824 ER PT J AU Hermann, BP Seidenberg, M Bell, B Woodard, A Rutecki, P Sheth, R AF Hermann, Bruce P. Seidenberg, Michael Bell, Brian Woodard, Austin Rutecki, Paul Sheth, Raj TI Comorbid Psychiatric Symptoms in Temporal Lobe Epilepsy: Association with Chronicity of Epilepsy and Impact on Quality of Life SO EPILEPSY & BEHAVIOR LA English DT Article DE quality of life; temporal lobe epilepsy; complex partial seizures; behavior; mood; depression AB Purpose. The goals of this work were to determine: (1) the nature and extent of differences in self-reported psychiatric symptoms between patients with temporal lobe epilepsy and matched healthy controls, (2) the relationship between chronicity (duration) of temporal lobe epilepsy and comorbid interictal psychiatric symptoms, and (3) the impact of comorbid psychiatric symptoms on self-reported health-related quality of life. Methods. Patients with temporal lobe epilepsy (n = 54) and healthy controls (n = 38) were administered the Symptom Checklist-90-Revised (SCL-90-R) to assess the nature and severity of psychiatric symptomatology and epilepsy patients completed the Quality of Life in Epilepsy-89 (QOLIE-89) to define health-related quality of life. Among epilepsy patients the SCL-90-R scales were examined in relation to chronicity of temporal lobe epilepsy as well as the impact of comorbid emotional-behavioral distress on health-related quality of life. Results. Compared with healthy controls, patients with epilepsy exhibited significantly higher (worse) scores across all but one of the 12 SCL-90-R scales. Among patients with epilepsy, increasing chronicity was associated with significantly higher (worse) scores across all SCL-90-R scales and increased emotional-behavioral distress was associated with lower (worse) scores across all 17 QOLIE-89 scales. Conclusion. Comorbid interictal psychiatric symptoms are elevated among patients with temporal lobe epilepsy compared with healthy controls and appear to be modestly associated with increasing chronicity (duration) of epilepsy. This comorbid emotional-behavioral distress is specifically associated with a significantly poorer health-related quality of life, and suggests that quality-of-life research should devote greater attention to the potential impact of comorbid psychiatric distress. (C) 2000 Academic Press C1 [Hermann, Bruce P.] Univ Wisconsin, Dept Neurol, Matthews Neuropsychol Lab, Madison, WI 53792 USA. [Seidenberg, Michael] Chicago Med Sch, Dept Psychol, N Chicago, IL 60064 USA. [Woodard, Austin; Rutecki, Paul] Middleton Vet Adm Hosp, Francis Forster Epilepsy Ctr, Madison, WI 53705 USA. RP Hermann, BP (reprint author), Univ Wisconsin, Dept Neurol, Matthews Neuropsychol Lab, 600 N Highland Ave, Madison, WI 53792 USA. EM hermann@neurology.wisc.edu FU NIH [37738]; NARSAD FX Supported in part by NIH 37738 and NARSAD. NR 22 TC 54 Z9 55 U1 2 U2 7 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1525-5050 J9 EPILEPSY BEHAV JI Epilepsy Behav. PD JUN PY 2000 VL 1 IS 3 BP 184 EP 190 DI 10.1006/ebeh.2000.0066 PG 7 WC Behavioral Sciences; Clinical Neurology; Psychiatry SC Behavioral Sciences; Neurosciences & Neurology; Psychiatry GA V21JJ UT WOS:000208203600007 PM 12609152 ER PT J AU Li, XL Carter, RH AF Li, XL Carter, RH TI CD19 signal transduction in normal human a cells: linkage to downstream pathways requires phosphatidylinositol 3-kinase, protein kinase C and Ca2+ SO EUROPEAN JOURNAL OF IMMUNOLOGY LA English DT Article DE CD19; B lymphocyte; signal transduction; human ID B-LYMPHOCYTE DEVELOPMENT; ANTIGEN RECEPTOR; TYROSINE KINASE; CROSS-LINKING; LINEAGE CELLS; MEMBRANE IGM; MAP KINASE; ACTIVATION; COMPLEX; PHOSPHORYLATION AB CD19 is required for normal antibody responses in mice. We have shown that CD19 enhances the activation of extracellular signal-regulated kinase (ERK) 2 by membrane (m) IgM but otherwise little is known of CD19 signaling in primary human cells. We now ask which pathways link CD19 with ERK2 in human tonsillar B cells. In analyses of signaling intermediates, the phosphatidylinositol 3-kinase (PI3K) inhibitor wortmannin partially suppressed the release of Ca2+ induced by coligation of CD19 and mlgM but the selective PKC inhibitor bisindolylmaieimide I (BIM-I) did not. The Cd2+ chelator 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid, BIM-I and wortmannin each had only a small effect on ERK2 activation induced by surface IgM alone but blocked the enhancement of that activation by CD19/mlgM coligation. To analyze the mitogen-activated protein kinase (MAPK) cascade, we measured activation of Raf, MAPK- or ERK kinase (MEK) 1 and ERK2. CD19 consistently enhanced activation of ERK2 and MEK1. However, synergistic activation of Raf was variably observed. in subpopulation analyses, synergistic activation of Raf1 was consistently observed in the IgD(low) but not in the lgD(high) cells. Thus, in normal human B cells, PI3K is upstream of the Ca2+ response while PI3K, Ca2+ release and protein kinase C are all required for ERK2 activation, and CD19 enhances the MAPK cascade at multiple levels, depending on the state of differentiation. C1 Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Dept Microbiol, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Carter, RH (reprint author), 409 LHRB,701 19th St S, Birmingham, AL 35294 USA. FU NIAID NIH HHS [R01 AI42265]; NIAMS NIH HHS [P60 AR20614] NR 50 TC 15 Z9 15 U1 0 U2 1 PU WILEY-V C H VERLAG GMBH PI BERLIN PA MUHLENSTRASSE 33-34, D-13187 BERLIN, GERMANY SN 0014-2980 J9 EUR J IMMUNOL JI Eur. J. Immunol. PD JUN PY 2000 VL 30 IS 6 BP 1576 EP 1586 DI 10.1002/1521-4141(200006)30:6<1576::AID-IMMU1576>3.0.CO;2-0 PG 11 WC Immunology SC Immunology GA 322KA UT WOS:000087507700007 PM 10898493 ER PT J AU Chandrasekar, B Colston, JT Geimer, J Cortez, D Freeman, GL AF Chandrasekar, B Colston, JT Geimer, J Cortez, D Freeman, GL TI Induction of nuclear factor kappa B but not kappa B-responsive cytokine expression during myocardial reperfusion injury after neutropenia SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Article DE reperfusion injury; ischemia; NF-kappa B; proinflammatory cytokines; neutrophils; anti-PMN antiserum; free radicals ID PROINFLAMMATORY CYTOKINE; POSTISCHEMIC MYOCARDIUM; ISCHEMIA; NEUTROPHILS; DEPLETION; DYSFUNCTION; ACTIVATION; LEUKOCYTE; DOG; MECHANISMS AB Neutrophils may contribute to myocardial ischemia/reperfusion (I/R) injury by generating reactive oxygen intermediates (ROIs). ROIs activate nuclear factor (NF)-kappa B, which regulates genes for cytokines with negative inotropic effects (interleukin [IL]-1 beta, IL-6, and tumor necrosis factor [TNF]-alpha). We investigated the impact of neutrophil depletion on NF-kappa B DNA binding activity, and expression of these cytokines during myocardial IIR injury. Male WKY rats (n = 28) received a single dose of antineutrophil antiserum (i/v). Twenty two hours later, when the peripheral blood neutrophil counts were profoundly decreased (94% reduction), the animals underwent 15 min of left anterior descending coronary artery ligation followed by reperfusion for 0.25, 0.5, 1, 2, 3, and 6 h (n = 4/group). Saline-treated animals underwent a similar protocol, and served as controls (n = 28, 4/group). Neutrophil accumulation, defined by myeloperoxidase activity, was present in controls, but not in anti-PMN antisera-treated animals (at least p <0.05 at 1, 2, 3, and 6 h R). Despite this difference, in both saline- and antiserum-treated animals, the GSH levels were very similar and fell significantly (p < 0.0001) at 15 min R; the levels increased gradually over time. In contrast, GSSG levels rose at 15 and 30 min R (p < 0.05), and declined thereafter. NF-kappa B DNA binding activity increased in both groups at 15 min and again at 3 h of R. Both NF-kappa Bp50 and p65 subunits were detected by supershift assay. In saline-injected controls both mRNA and protein for IL-1 beta, IL-6, and TNF-alpha were detected at 1 h R; levels remained high until 3 h, then fell (except IL-6, which was elevated at 6 h). In neutropenic animals, however, a significant decrease in mRNA (at least 1.7-fold, p ( 0.05) as well as protein levels (at least 2.3-fold, p ( 0.01) for all three cytokines was observed. Thus, while neutrophils had minimal effects on oxidative stress (GSH/GSSG) and oxidative stress-responsive NF-kappa B activity, they contributed significantly to myocardial cytokine expression. (C) 2000 Elsevier Science Inc. C1 S Texas Vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. RP Freeman, GL (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med Cardiol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. NR 36 TC 23 Z9 25 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PD JUN 1 PY 2000 VL 28 IS 11 BP 1579 EP 1588 DI 10.1016/S0891-5849(00)00273-2 PG 10 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 344GG UT WOS:000088750400001 PM 10938453 ER PT J AU Pahlavani, MA AF Pahlavani, MA TI Caloric restriction and immunosenescence: A current perspective SO FRONTIERS IN BIOSCIENCE-LANDMARK LA English DT Review DE caloric restriction; immune function; signal transduction; aging; review ID TRANSCRIPTION FACTOR NFAT; HUMAN T-LYMPHOCYTES; DIETARY RESTRICTION; FOOD RESTRICTION; IMMUNE FUNCTIONS; FISCHER-344 RATS; PERIPHERAL-BLOOD; RHESUS-MONKEYS; WISTAR RATS; PRONE MICE AB The age-related decrease in immunologic function is believed to be the major predisposing factor contributing to increased morbidity and mortality with age. Hence, the restoration of immunologic function is expected to have a beneficial effect in reducing pathology and maintaining a healthy condition in advanced age. Among various intervention strategies, caloric restriction (CR) has been shown to be the most powerful modulator of aging process. It is the most efficacious means of increasing longevity and reducing pathology. Several mechanisms have been proposed to explain its beneficial and robust action on various physiological systems, including the immune system. Experimental evidence suggests that CR increases longevity and reduces pathology through its action on the immune system. The observation that CR attenuates immunosenescence has provided a rationale for studying whether CR exerts its action through modulation of gene expression. The available data indicate that the effect of CR on signal transduction and gene expression can vary considerably from gene to gene and from one signaling molecule to another. This review summarizes the studies on the influence of CR on aging immune system and discusses the current state of knowledge on the molecular mechanisms responsible for the immunomodulatory action of caloric restriction. C1 S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. RP Pahlavani, MA (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, GRECC 182, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. EM Pahlavani@uthscsa.edu FU NIA NIH HHS [AG00677, AG14088] NR 63 TC 30 Z9 30 U1 0 U2 1 PU FRONTIERS IN BIOSCIENCE INC PI MANHASSET PA C/O NORTH SHORE UNIV HOSPITAL, BIOMEDICAL RESEARCH CENTER, 350 COMMUNITY DR, MANHASSET, NY 11030 USA SN 1093-9946 J9 FRONT BIOSCI-LANDMRK JI Front. Biosci. PD JUN 1 PY 2000 VL 5 BP D580 EP D587 DI 10.2741/Pahlavani PG 8 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 360JK UT WOS:000089664000002 PM 10833464 ER PT J AU Savides, TJ Jensen, DM AF Savides, TJ Jensen, DM TI Therapeutic endoscopy for nonvariceal gastrointestinal bleeding SO GASTROENTEROLOGY CLINICS OF NORTH AMERICA LA English DT Article ID PEPTIC-ULCERS; EPINEPHRINE INJECTION; CONTROLLED TRIAL; BAND LIGATION; MULTIPOLAR ELECTROCOAGULATION; DIEULAFOYS-DISEASE; RANDOMIZED TRIAL; NATURAL-HISTORY; VISIBLE VESSEL; SENTINEL CLOT AB This article reviews the role of therapeutic endoscopy in the diagnosis and treatment of nonvariceal upper and lower gastrointestinal (GI) hemorrhage. The initial approach to patients with GI bleeding is reviewed. Endoscopic treatment of various stigmata of recent peptic ulcer hemorrhage is discussed in detail. Management of less common causes of nonvariceal bleeding, such as Dieulafoy's lesions, Mallory-Weiss tears, angiomas, and bleeding colonic diverticula is described. Recommendations for endoscopic techniques are based on the results of UCLA-CURE hemostasis studies. C1 Univ Calif San Diego, Dept Clin Med, Div Gastroenterol, San Diego, CA 92103 USA. Univ Calif Los Angeles, Dept Med, Div Digest Dis, Los Angeles, CA USA. VA Greater Los Angeles Hlth Syst, Los Angeles, CA USA. RP Savides, TJ (reprint author), UCSD Gastroenterol 8413, 200 W Arbor Dr, San Diego, CA 92103 USA. NR 63 TC 50 Z9 55 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0889-8553 J9 GASTROENTEROL CLIN N JI Gastroenterol. Clin. North Am. PD JUN PY 2000 VL 29 IS 2 BP 465 EP + DI 10.1016/S0889-8553(05)70123-0 PG 24 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 318KQ UT WOS:000087283500008 PM 10836190 ER PT J AU Saint, S Veenstra, DL Lipsky, BA AF Saint, S Veenstra, DL Lipsky, BA TI The clinical and economic consequences of nosocomial central venous catheter-related infection: Are antimicrobial catheters useful? SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT Risk and Prevention Conferene CY FEB 24-25, 2000 CL PARIS, FRANCE ID BLOOD-STREAM INFECTION; CRITICALLY ILL PATIENTS; ANTISEPTIC-IMPREGNATED CATHETER; CONTINUOUS QUALITY IMPROVEMENT; RANDOMIZED CONTROLLED TRIALS; INTENSIVE-CARE UNIT; BACTERIAL-COLONIZATION; PARENTERAL-NUTRITION; ATTRIBUTABLE MORTALITY; COST-EFFECTIVENESS AB Central venous catheters (CVCs) are essential for many hospitalized patients, but they are associated with important infectious complications. Recent studies have indicated that CVCs coated with antimicrobial agents reduce the incidence of catheter-related bloodstream infection (CR BSI). To estimate the clinical and economic consequences of short-term central venous catheter-related infection and the potential usefulness of antimicrobial-coated catheters, we reviewed and synthesized the available relevant literature. Statistical pooling was used to estimate the incidence of both catheter colonization and CR BSI. The attributable mortality of CR BSI was also evaluated. In addition, the economic consequences of both local and systemic catheter-related infection was estimated from literature reports that used micro-costing and other techniques. Among patients in whom standard, noncoated CVCs are in place for an average of 8 days, 24.7% are expected to develop catheter colonization (95% confidence interval [CI95], 22.00%-27.5%). Approximately 5.2% (CI95 3.9%-6.5%) will develop CR BSI. The attributable mortality of CR BSI remains unclear, but recent studies are consistent with a range from 4% to 20%;. An episode of local catheter-related infection leads to an additional cost of approximately $400, whereas the additional cost of CR BSI ranges from approximately $6,005 to $9,738. Formal economic analyses indicate that CVCs coated with antibacterial agents (such as chlorhexidine-silver sulfadiazine or minocycline-rifampin) likely reduce infectious complications, yielding economic advantages. In light of the substantial clinical and economic burden of catheter-related infection, hospital personnel should adopt proven cost-effective methods to reduce this common and important nosocomial complication (Infect Control Hosp Epidemiol 2000;21:375-380). C1 Univ Washington, Sch Pharm, Pharmaceut Outcomes Res & Policy Program, Seattle, WA 98195 USA. Univ Michigan, Sch Med, Dept Med, Ann Arbor, MI 48109 USA. Ann Arbor Vet Affairs Hlth Serv, Res & Dev Serv, Ann Arbor, MI USA. Vet Affairs Puget Sound Healthcare Syst, Seattle Div, Seattle, WA USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. RP Veenstra, DL (reprint author), Univ Washington, Sch Pharm, Pharmaceut Outcomes Res & Policy Program, Box 357630, Seattle, WA 98195 USA. OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 48 TC 80 Z9 81 U1 0 U2 2 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD JUN PY 2000 VL 21 IS 6 BP 375 EP 380 DI 10.1086/501776 PG 6 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 325GK UT WOS:000087667700004 PM 10879567 ER PT J AU Mystkowski, P Shankland, E Schreyer, SA LeBouef, RC Schwartz, RS Cummings, DE Kushmerick, M Schwartz, MW AF Mystkowski, P Shankland, E Schreyer, SA LeBouef, RC Schwartz, RS Cummings, DE Kushmerick, M Schwartz, MW TI Validation of whole-body magnetic resonance spectroscopy as a tool to assess murine body composition SO INTERNATIONAL JOURNAL OF OBESITY LA English DT Article DE proton spectroscopy; obesity; body composition; mice ID EARLY-ONSET OBESITY; TARGETED DISRUPTION; RECEPTOR; RATS; MICE; ABSORPTIOMETRY; MUTATION; HUMANS; GENE AB OBJECTIVE: To evaluate proton magnetic resonance spectroscopy (MRS) as a tool for the non-invasive assessment of murine body composition. DESIGN: Twenty C57/BL6 male mice with a wide range of body adiposities underwent both pre- and post-mortem whole-body MRS to assess body composition. MRS measures were compared to the results obtained by chemical carcass analysis, the current 'gold standard' for determination of body composition. MEASUREMENTS: Areas under the curve (AUC) for lipid and water peaks of whole body MRS spectra (AUC(lipid) and AUC(H2O), respectively) were used to determine percentages of body fat (%FAT(MRS)) and fat free mass by MRS (%FFMMRS) Total body fat, total body water, fat free mass, and total lean mass were determined by chloroform/methanol extraction of lipid from dessicated whole carcass and compared to MRS measures (%FAT(MRS), %FFMMRS, AUC(lipid), and AUC(H2O)) The variability of the MRS technique was assessed by determining the coefficients of variation (COV) associated with %FAT(MRS), AUC(lipid), and AUC(H2O) for mice of three different adiposities. RESULTS: %FAT(MRS) in live mice was highly correlated with body fat percentage (r = 0.994, P < 0.001) and total body fat (r = 0.980, P < 0.001) derived from chemical carcass analysis over a broad range of adiposities (7-48% body fat content by carcass analysis). There was no difference in %FAT(MRS) measured pre- vs post-mortem (r = 1.00, P < 0.001). AUC(lipid) was highly correlated with chemically derived total fat mass (r = 0.996, P < 0.001) and body fat percentage (r = 0.981, P < 0.001), while %FFMMRS was strongly correlated to chemical determinations of percentage body water (r = 0.994, P < 0.001), percentage fat free mass (r = 0.993, P < 0.001), and percentage lean mass (r = 0.792, P < 0.001). AUC(H2O) was strongly associated with carcass analysis determinations of total body water (r = 0.964, P < 0.001), total fat free mass (r = 0.953, P < 0.001), and total lean mass (r = 0.89, P < 0.001). In mice of 6%, 12%, and 43% body fat, COVs determined for %FAT(MRS) and AUC(lipid) were less than 10%. The COVs for AUC(H2O) were less than 2%. CONCLUSIONS: MRS provides precise, accurate, rapid, and non-invasive measures of body fat, body water, fat free mass, and lean mass in living mice with a broad range of adiposities. C1 Univ Washington, Harborview Med Ctr, Div Endocrinol Metab, Dept Internal Med, Seattle, WA 98104 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Pathobiol & Nutr, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Radiol, Seattle, WA 98195 USA. Univ Colorado, Hlth Sci Ctr, Dept Internal Med, Denver, CO USA. RP Schwartz, MW (reprint author), Univ Washington, Harborview Med Ctr, Div Endocrinol Metab, Dept Internal Med, 325 9Th Ave,Box 359757, Seattle, WA 98104 USA. RI Schwartz, Michael/H-9950-2012 FU NHLBI NIH HHS [HL07028-24]; NIDDK NIH HHS [DK52989]; NINDS NIH HHS [NS32273] NR 22 TC 35 Z9 36 U1 0 U2 2 PU NATURE PUBLISHING GROUP PI BASINGSTOKE PA HOUNDMILLS, BASINGSTOKE RG21 6XS, HAMPSHIRE, ENGLAND SN 0307-0565 J9 INT J OBESITY JI Int. J. Obes. PD JUN PY 2000 VL 24 IS 6 BP 719 EP 724 DI 10.1038/sj.ijo.0801231 PG 6 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 321QN UT WOS:000087466300008 PM 10878678 ER PT J AU Schlesinger, N Neustadter, L Schumacher, HR AF Schlesinger, N Neustadter, L Schumacher, HR TI Lytic bone lesions as a prominent feature in Waldenstrom's macroglobulinemia SO JCR-JOURNAL OF CLINICAL RHEUMATOLOGY LA English DT Article DE osteolysis; calcifications; Waldenstrom's macroglobulinemia ID MULTIPLE-MYELOMA; CALCIFICATION AB We report a patient with Waldenstrom's macroglobulinemia who had diffuse plasmacytoid infiltration in the bone marrow, immunoglobulin M monoclonal gammopathy, wide-spread osteolytic lesions, recurrent pathologic fractures, and diffuse subcutaneous soft tissue calcifications. The bony lesions were even more pronounced than those usually seen with multiple myeloma and are a rare manifestation of this disease. Such malignant plasma-cell dyscrasia with macroglobulinemia and lytic osseous lesions is best handled clinically according to its general presenting features rather than according to whether it is Waldenstrom's macroglobulinemia or an immunoglobulin M myeloma. The bone lesions may require local palliative radiotherapy and orthopedic measures. C1 Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Med, Rheumatol Sect, Newark, NJ 07103 USA. Univ Penn, Sch Med, Dept Radiol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Rheumatol, Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Arthrit Immunol Ctr, Philadelphia, PA USA. RP Schlesinger, N (reprint author), Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Med, Rheumatol Sect, MSB I-506,185 S Orange Ave, Newark, NJ 07103 USA. NR 14 TC 3 Z9 3 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1076-1608 J9 JCR-J CLIN RHEUMATOL JI JCR-J. Clin. Rheumatol. PD JUN PY 2000 VL 6 IS 3 BP 150 EP 153 DI 10.1097/00124743-200006000-00007 PG 4 WC Rheumatology SC Rheumatology GA 322XJ UT WOS:000087534300010 PM 19078464 ER PT J AU Roder, ME Schwartz, RS Prigeon, RL Kahn, SE AF Roder, ME Schwartz, RS Prigeon, RL Kahn, SE TI Reduced pancreatic B cell compensation to the insulin resistance of aging: Impact on proinsulin and insulin levels SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Article ID DEPENDENT DIABETES-MELLITUS; IMPAIRED GLUCOSE-TOLERANCE; DISPROPORTIONATELY ELEVATED PROINSULIN; JAPANESE-AMERICAN MEN; SECRETORY CAPACITY; INTACT PROINSULIN; PLASMA-GLUCOSE; AGE; NIDDM; SENSITIVITY AB Type 2 diabetes mellitus is associated with insulin resistance, reduced B cell function, and an increase in the proinsulin (PI) to immunoreactive insulin (IRI) ratio (PI/IRI); the latter is thought to be an indication of B cell dysfunction. Normal aging is associated with insulin resistance and reduced B cell function, but it is not known whether changes in PI and the PI/IRI ratio are also a feature of the aging-associated B cell dysfunction. Therefore, we tested whether the aging-associated changes in insulin sensitivity and B cell function result in changes in PI and IRI levels that are proportionate or whether they are disproportionate as in type 2 diabetes. Twenty-six healthy older (mean +/- SEM age, 67 +/- 1 yr) and 22 younger (28 +/- 1 yr) subjects with similar body mass indexes (27.9 +/- 0.6 vs. 26.3 +/- 1.0 kg/m(2)) were studied. PI was measured by a RIA recognizing both intact PI and its conversion intermediates. The insulin sensitivity index (S-I) was quantified using the minimal model, and B cell function was measured as fasting insulin levels, the acute insulin response to glucose (AIRglucose), and as the acute insulin response to arginine at maximal glycemic potentiation (AIRmax). B cell function was also adjusted for S-I based on the known hyperbolic relationship between these two variables. Older and younger subjects had similar fasting glucose (5.3 +/- 0.1 vs. 5.2 +/- 0.1 mmol/L), IRI (83 +/- 8 vs. 76 +/- 9 pmol/L), PI (8.9 +/- 0.8 vs. 10.6 +/- 2.0 pmol/L), and PI/IRI ratio (12.3 +/- 1.3% vs. 13.9 +/- 1.6%; all P = NS) despite a 50% reduction of insulin sensitivity (S-I, 1.94 +/- 0.21 vs. 3.88 +/- 0.38 x 10(-5) min(-1)/pmol.L; P < 0.001) and in B cell function [S-I x fasting IRI, 139 +/- 18 vs. 244 +/- 24 x 10(-5) (P < 0.001); S-I x AIRglucose, 0.75 +/- 0.13 vs. 1.70 +/- 0.15 x 10(-2) min(-1) (P < 0.001); S-I x AIRmax, 3.63 +/- 0.53 vs. 6.81 +/- 0.70 x 10(-2) min(-1) (P < 0.001)] in the older subjects. These findings suggest that the B cell dysfunction in older subjects is not associated with disproportionate proinsulinemia. However, in older subjects the B cell response to the insulin resistance of aging is reduced whether measured as fasting levels of PI or IRI or as the acute response to secretagogues. Thus, when examined in terms of the degree of insulin sensitivity, the lower fasting IRI levels in older subjects suggest that the utility of fasting insulin levels as a surrogate measure of insulin resistance in older individuals may be limited. C1 Harborview Med Ctr, Vet Affairs Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Dept Med, Seattle, WA 98108 USA. Harborview Med Ctr, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Gerontol & Geriatr Med, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98108 USA. RP Roder, ME (reprint author), Univ Copenhagen, Hillerod Sygehus, Dept Endocrinol F, Helsevej 2, DK-3400 Hillerod, Denmark. EM mir@dadlnet.dk OI Kahn, Steven/0000-0001-7307-9002 FU NIDDK NIH HHS [DK-12829, DK-02654, DK-17047] NR 47 TC 37 Z9 40 U1 1 U2 4 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X EI 1945-7197 J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD JUN PY 2000 VL 85 IS 6 BP 2275 EP 2280 DI 10.1210/jc.85.6.2275 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 339CR UT WOS:000088460500035 PM 10852463 ER PT J AU Roberts, LJ Neal, DJ Kivlahan, DR Baer, JS Marlatt, GA AF Roberts, LJ Neal, DJ Kivlahan, DR Baer, JS Marlatt, GA TI Individual drinking changes following a brief intervention among college students: Clinical significance in an indicated preventive context SO JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY LA English DT Article ID NORMATIVE COMPARISONS; PSYCHOTHERAPY; ALCOHOL AB This study investigated the clinical significance of previously reported statistically significant mean reductions in drinking and related problems among college students in a randomized trial of a brief indicated preventive intervention (G. A. Marlatt et al., 1998). Data were analyzed over a 2-year follow-up for participants from a high-risk intervention group (n = 153), a high-risk control group (n = 160), and a functional comparison group (n = 77). A risk cutpoint for each dependent measure was based on the functional comparison group distribution. Compared with the high-risk controls, more individuals in the high-risk intervention group improved and fewer worsened, especially on alcohol-related problems and, to a lesser extent, on drinking pattern variables. These data from a prevention context clarify the magnitude and direction of individual change obscured by group means. C1 Vet Affairs Puget Sound Hlth Care Syst, CESATE, Seattle, WA 98108 USA. Univ Washington, Dept Psychol, Addict Behav Res Ctr, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Roberts, LJ (reprint author), Vet Affairs Puget Sound Hlth Care Syst, CESATE, 1660 S Columbian Way 116 S-MATCH, Seattle, WA 98108 USA. FU NIAAA NIH HHS [5R3A AA05591] NR 24 TC 41 Z9 42 U1 1 U2 3 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0022-006X J9 J CONSULT CLIN PSYCH JI J. Consult. Clin. Psychol. PD JUN PY 2000 VL 68 IS 3 BP 500 EP 505 DI 10.1037/0022-006X.68.3.500 PG 6 WC Psychology, Clinical SC Psychology GA 324ZH UT WOS:000087651500014 PM 10883566 ER PT J AU Lam, EWN Hammad, HM Zwacka, R Darby, CJ Baumgardner, KR Davidson, BL Oberley, TD Engelhardt, JF Oberley, LW AF Lam, EWN Hammad, HM Zwacka, R Darby, CJ Baumgardner, KR Davidson, BL Oberley, TD Engelhardt, JF Oberley, LW TI Immunolocalization and adenoviral vector-mediated manganese superoxide dismutase gene transfer to experimental oral tumors SO JOURNAL OF DENTAL RESEARCH LA English DT Article DE hamster cheek pouch; oral cancer; manganese superoxide dismutase; adenoviral gene transfer ID SMOOTH-MUSCLE CELLS; SYRIAN-HAMSTER TISSUES; IMMUNOHISTOCHEMICAL LOCALIZATION; GLUTATHIONE-PEROXIDASE; MALIGNANT PHENOTYPE; ANTIOXIDANT ENZYMES; KIDNEY DEVELOPMENT; EPITHELIAL-CELLS; PROSTATE-CANCER; NECROSIS FACTOR AB The anti-oxidant enzyme system protects cellular macromolecules against damage from reactive oxygen species. One component of this system, manganese superoxide dismutase (MnSOD), has also been shown to display tumor suppressor gene-like activity. The purpose of this study was to examine changes in MnSOD expression during hamster cheek pouch carcinogenesis, and the effects of MnSOD overexpression using an adenoviral vector. Tumor induction was carried out using 7,12-dimethylbenz[alpha] anthracene. Animals were killed at periodic intervals, and cheek pouch tissues were excised and examined for MnSOD expression by immunohistochemistry and digital image analysis. We observed a reduction in MnSOD expression as early as 2 weeks after the start of carcinogen application. Low MnSOD expression persisted until the end of the 23-week experimental period. Solid hamster cheek pouch carcinoma xenografts were then established in nude mice. An adenoviral vector encoding the human MnSOD gene was delivered to the xenografts by direct injection. We observed high, immediate expression of MnSOD in the xenografts that persisted for 10 days following cessation of viral construct delivery. Delivery of the MnSOD construct resulted in a maximal 50% reduction in tumor growth compared with untreated controls. Our results suggest that MnSOD may be a tumor suppressor gene in the hamster cheek pouch model system. C1 Univ Iowa, Coll Med, Dept Internal Med, Iowa City, IA 52242 USA. Univ Iowa, Coll Med, Dept Anat & Cell Biol, Iowa City, IA 52242 USA. Jordan Univ Sci & Technol, Fac Dent, Irbid, Jordan. Western Gen Hosp, MRC, Human Genet Unit, Edinburgh EH4 2XU, Midlothian, Scotland. Univ Michigan, Dept Cariol Restorat Sci & Endodont, Ann Arbor, MI 48109 USA. William S Middleton Mem Vet Hosp, Madison, WI USA. Univ Iowa, Coll Med, Dept Radiol, Iowa City, IA 52242 USA. RP Lam, EWN (reprint author), Univ Alberta, Dept Dent, Dent Pharm Ctr 2085, Edmonton, AB T6G 2N8, Canada. FU NCI NIH HHS [P01-CA66081]; NIDCR NIH HHS [P50 DE-10758]; NIDDK NIH HHS [1R01 DK-51315] NR 60 TC 21 Z9 24 U1 0 U2 1 PU AMER ASSOC DENTAL RESEARCH PI ALEXANDRIA PA 1619 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0022-0345 J9 J DENT RES JI J. Dent. Res. PD JUN PY 2000 VL 79 IS 6 BP 1410 EP 1417 PG 8 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 325TZ UT WOS:000087693600010 PM 10890721 ER PT J AU Mayfield, JA Reiber, GE Nelson, RG Greene, T AF Mayfield, JA Reiber, GE Nelson, RG Greene, T TI Do foot examinations reduce the risk of diabetic amputation? SO JOURNAL OF FAMILY PRACTICE LA English DT Article DE diabetic foot; foot examinations [non-MESH]; foot ulcer; amputation ID PIMA-INDIANS; CARE; PREVENTION; MELLITUS; EDUCATION; SYSTEM AB BACKGROUND Foot examinations are widely recommended as a means to reduce amputation risk, but no investigators have studied their independent effect on this outcome. METHODS We conducted a population-based case-control study of primary care provided to Pima Indians from the Gila River Indian Community. Sixty-one Pima Indians with type 2 diabetes and a first lower-extremity amputation between January 1, 1985, and December 31, 1992, were compared with 183 people who had no amputation by December 31, 1992. The type of foot examination conducted, comorbid conditions, and foot risk factors present in the 36 months before the pivotal event were abstracted front medical records. AU ulcer care was excluded. The independent effect of foot examinations on the risk of amputation was assessed by logistic regression. RESULTS During the 36 study months, 1857 fool examinations were performed on 244 subjects. The median number of preventive foot examinations was 7 for case patients and 3 for control patients. After controlling for differences in comorbid conditions and foot risk conditions, the risk of amputation for persons with 1 or more foot examinations was an odds ratio (OR) of 0.55 (95% confidence interval [CI], 0.2-1.7; P=.31). The risk of amputation associated with written comments of nonadherence with therapeutic foot care recommendations or diabetic medication was an OR of 1.9 (95% CZ, 0.9-4.3; P=.10). CONCLUSIONS Our study failed to demonstrate that foot examinations decrease the risk of amputation in Pima Indians with type 2 diabetes. However, foot examinations detect high-risk conditions for which specific interventions have been shown to be effective in reducing amputation risk. C1 Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res Ctr, Seattle, WA USA. NIDDKD, Phoenix Epidemiol & Clin Res Branch, Phoenix, AZ USA. Indiana Univ, Dept Family Med, Bowen Res Ctr, Indianapolis, IN 46204 USA. Cleveland Clin Fdn, Cleveland, OH 44195 USA. RP Mayfield, JA (reprint author), 1660 So Columbia way,MS 152, Seattle, WA 98108 USA. RI Nelson, Robert/B-1470-2012 FU AHRQ HHS [HS07238] NR 21 TC 15 Z9 17 U1 0 U2 0 PU DOWDEN PUBLISHING CORP PI MONTVALE PA 110 SUMMIT AVE, MONTVALE, NJ 07645-1712 USA SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD JUN PY 2000 VL 49 IS 6 BP 499 EP 504 PG 6 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 324ZT UT WOS:000087652400001 PM 10923547 ER PT J AU Camicioli, R Willert, P Lear, J Grossmann, S Kaye, J Butterfield, P AF Camicioli, R Willert, P Lear, J Grossmann, S Kaye, J Butterfield, P TI Dementia in rural primary care practices in Lake County, Oregon SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article ID UNITED-STATES POPULATION; COGNITIVE IMPAIRMENT; GENERAL-PRACTITIONERS; ALZHEIMERS-DISEASE; ELDERLY PATIENTS; PREVALENCE; DIAGNOSIS; EPIDEMIOLOGY; GUIDELINES; CONSENSUS AB Procedures used in assessing patients with dementia in rural settings are little studied. Among all patients aged 65 years and older in the four primary care practices in Lake County, Oregon, dementia cases were identified from computerized office databases using preselected International Classification of Diseases, Ninth Edition, codes. A semi-structured chart review determined (1) a dementia diagnosis, (2) cognitive and functional domains assessed, and (3) diagnostic studies performed. Of 1540 available records, 30 had dementia. Nineteen of them met National Institute of Neurological and Communicative Diseases and Stroke-Alzheimer's Disease and Related Disorders Association criteria for Alzheimer's disease (AD). Cognitive impairment was documented in 73% of the 51 identified charts and all with AD. Laboratory studies were recorded in 33% overall and in 42% with AD. Neuroimaging was documented in 18% overall and in 16% with AD. The prevalence of documented dementia in these rural practices may be low, possibly because cases of mild dementia may not be labeled as such. Laboratory studies were performed in a minority of cases of dementia. C1 Oregon Hlth Sci Univ, Oregon Aging & Alzheimer Dis Ctr, Dept Neurol, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Neurol Serv, Portland, OR USA. Oregon Hlth Sci Univ, Ctr Res Occupat & Environm Toxicol, Portland, OR 97201 USA. Montana State Univ, Coll Nursing, Bozeman, MT 59717 USA. RP Camicioli, R (reprint author), Oregon Hlth Sci Univ, Oregon Aging & Alzheimer Dis Ctr, Dept Neurol, Hatfield Res Bldg,CR131,3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. OI Kaye, Jeffrey/0000-0002-9971-3478; Camicioli, Richard/0000-0003-2977-8660 FU NIA NIH HHS [AG08017] NR 42 TC 14 Z9 14 U1 3 U2 3 PU DECKER PERIODICALS INC PI HAMILTON PA 4 HUGHSON STREET SOUTH PO BOX 620, LCD 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD SUM PY 2000 VL 13 IS 2 BP 87 EP 92 DI 10.1177/089198870001300207 PG 6 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 333TY UT WOS:000088147900007 PM 10912730 ER PT J AU Levine, B Maesaka, JK Smith, MC Levy, EM AF Levine, B Maesaka, JK Smith, MC Levy, EM TI The safety and efficacy of omapatrilat in patients with hypertension and renal insufficiency SO JOURNAL OF HYPERTENSION LA English DT Meeting Abstract C1 W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. BMS PRI, Princeton, NJ USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0263-6352 J9 J HYPERTENS JI J. Hypertens. PD JUN PY 2000 VL 18 SU 2 BP S96 EP S96 PG 1 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 323YY UT WOS:000087593800319 ER PT J AU Weisbart, RH Baldwin, R Huh, B Zack, DJ Nishimura, R AF Weisbart, RH Baldwin, R Huh, B Zack, DJ Nishimura, R TI Novel protein transfection of primary rat cortical neurons using an antibody that penetrates living cells SO JOURNAL OF IMMUNOLOGY LA English DT Article ID SYSTEMIC LUPUS-ERYTHEMATOSUS; GLUTATHIONE-PEROXIDASE; SUPEROXIDE-DISMUTASE; MONONUCLEAR-CELLS; HYDROGEN-PEROXIDE; DNA; MURINE; MECHANISMS; NUCLEUS; IGG AB An Ah-based system to deliver functional proteins into neurons was developed using the murine mAb, mAb 3E10. This was achieved by covalently conjugating catalase to the Ab so that the conjugate retained high activity for the degradation of hydrogen peroxide, Three-dimensional fluorescence microscopy was used to demonstrate penetration of the Ab into the nucleus of living primary cortical neurons. The Ab conjugate localized in both the cytoplasm and nucleus, Retention of catalase activity after penetration and distribution of conjugate was demonstrated by reduction in cell death following exposure of treated neurons to hydrogen peroxide, These studies illustrate the potential of this method for the intracellular delivery of therapeutic proteins. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Div Rheumatol, Sepulveda, CA 91343 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Dept Neurol, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90095 USA. RP Weisbart, RH (reprint author), Vet Affairs Med Ctr, 16111 Plummer St, Sepulveda, CA 91343 USA. FU NIDDK NIH HHS [R29DK50684] NR 30 TC 22 Z9 23 U1 0 U2 1 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD JUN 1 PY 2000 VL 164 IS 11 BP 6020 EP 6026 PG 7 WC Immunology SC Immunology GA 316EN UT WOS:000087154800060 PM 10820286 ER PT J AU Schellenberg, GD Dawson, G Wijsman, EM AF Schellenberg, GD Dawson, G Wijsman, EM TI Genetic studies of autism SO JOURNAL OF INTELLECTUAL DISABILITY RESEARCH LA English DT Meeting Abstract C1 Univ Washington, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND SN 0964-2633 J9 J INTELL DISABIL RES JI J. Intell. Disabil. Res. PD JUN-AUG PY 2000 VL 44 MA 1020 BP 453 EP 453 PN 3-4 PG 1 WC Education, Special; Genetics & Heredity; Clinical Neurology; Psychiatry; Rehabilitation SC Education & Educational Research; Genetics & Heredity; Neurosciences & Neurology; Psychiatry; Rehabilitation GA 343HV UT WOS:000088697701020 ER PT J AU Every, NR Maynard, C Schulman, K Ritchie, JL AF Every, NR Maynard, C Schulman, K Ritchie, JL TI The association between institutional primary angioplasty procedure volume and outcome in elderly Americans SO JOURNAL OF INVASIVE CARDIOLOGY LA English DT Article DE hospital volume; mortality rate; PTCA ID TRANSLUMINAL CORONARY ANGIOPLASTY; ACUTE MYOCARDIAL-INFARCTION; COLLEGE-OF-CARDIOLOGY; TASK-FORCE; EXPERIENCE; MORTALITY; HOSPITALS; STATEMENT AB Background The association between greater procedure volume and improved patient outcome in cardiac procedures has been established in percutaneous transluminal coronary angioplasty; (PTCA), coronary stent placement and coronary bypass surgery, The association between primary angioplasty volume and outcome has not been evaluated. Methods. We evaluated the association between the volume of primary angioplasty procedures with short- and long-term outcome in 6,124 patients with documented acute myocardial infarction, Patients without shock on presentation treated with primary coronary angioplasty within 12 hours of hospital admission were selected from consecutive infarct patients included in the Cooperative Cardiovascular Project database. Patients were divided into quartiles based on the volume of primary PTCA procedures performed at their admitting hospital. Results. The majority of United States (US) hospitals performed less than three primary PTCA procedures per month. Patients admitted to hospitals in the lowest volume quartile of primary PTCA had 31% higher 30-day mortality than those admitted to the highest volume quartile, After adjustment for baseline differences in patient characteristics, there was an association between admission to higher volume primary PTCA hospitals and lower 30-day mortality (odds ratio per volume quartile = 0,91; 95% confidence interval = 0,83-0,99), Conclusion. Eighty-two percent of US hospitals perform less than three primary? PTCA procedures per month. In elderly Americans treated with primary PTCA, me observed an association between admission to higher volume hospitals and lower short- and long-term mortality. This association was independent of total PTCA volumes. C1 VA Puget Sound Healthcare Syst, HSR&D Field Program, Seattle, WA 98108 USA. RP Every, NR (reprint author), VA Puget Sound Healthcare Syst, HSR&D Field Program, 1660 S Columbian Way HSR&D 152, Seattle, WA 98108 USA. RI Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814 NR 19 TC 13 Z9 13 U1 0 U2 0 PU HEALTH MANAGEMENT PUBLICATIONSINC PI WAYNE PA 950 WEST VALLEY RD, STE 2800, WAYNE, PA 19087 USA SN 1042-3931 J9 J INVASIVE CARDIOL JI J. Invasive Cardiol. PD JUN PY 2000 VL 12 IS 6 BP 303 EP 308 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 321VR UT WOS:000087475800005 PM 10859715 ER PT J AU Aravagiri, M Marder, SR AF Aravagiri, M Marder, SR TI Simultaneous determination of risperidone and 9-hydroxyrisperidone in plasma by liquid chromatography/electrospray tandem mass spectrometry SO JOURNAL OF MASS SPECTROMETRY LA English DT Article DE risperidone; 9-hydroxyrisperidone; liquid chromatography/electrospray tandem mass spectrometry; plasma; pharmacokinetics ID ELECTROCHEMICAL DETECTION; SCHIZOPHRENIC-PATIENTS; PERFORMANCE; METABOLISM; EXCRETION AB A simple and highly sensitive liquid chromatographic/electrospray tandem mass spectrometric (LC/MS/MS) assay was developed for the simultaneous determination of risperidone (RSP) and its major circulating metabolite 9-hydroxyrisperidone (9-OH-RSP) in the plasma of humans and rats, A simple one-step solvent extraction with 15% methylene chloride in pentane was used to isolate the compounds from plasma. The compounds were eluted from a phenyl-hexyl column and detected with a Perkin-Elmer SCIEX API2000 triple-quadrupole mass spectrometer using positive ion atmospheric pressure electrospray ionization and multiple reaction monitoring. The assay was linear over the range 0.1-100 ng ml(-1) when 0.5 ml of plasma was used in the extraction. The overall intra- (within-day) and inter- (between days) assay variations were <11%. The variations in the concentrations of two long-term quality control samples from pooled patient plasma samples analyzed over a period of 6 months were similar to 10%. The analysis time for each sample was 4 min and more than 100 samples could be analyzed in one day by running the system overnight. The assay is simple, highly sensitive, selective, precise and fast, This method is being used for the therapeutic drug monitoring of schizophrenic patients treated with RSP and to study the pharmacokinetics and tissue distribution of RSP and 9-OH-RSP in rats. Copyright (C) 2000 John Wiley Br Sons, Ltd. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Psychopharmacol Unit, Los Angeles, CA 90073 USA. RP Aravagiri, M (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Psychopharmacol Unit, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NIMH NIH HHS [MH41573] NR 18 TC 48 Z9 51 U1 0 U2 6 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 1076-5174 J9 J MASS SPECTROM JI J. Mass Spectrom. PD JUN PY 2000 VL 35 IS 6 BP 718 EP 724 DI 10.1002/1096-9888(200006)35:6<718::AID-JMS999>3.0.CO;2-O PG 7 WC Biophysics; Chemistry, Organic; Spectroscopy SC Biophysics; Chemistry; Spectroscopy GA 324ZE UT WOS:000087651200008 PM 10862124 ER PT J AU Allen, DN Seaton, BE Goldstein, G Sanders, RD Gurklis, RD Peters, JL van Kammen, DP AF Allen, DN Seaton, BE Goldstein, G Sanders, RD Gurklis, RD Peters, JL van Kammen, DP TI Neuroanatomic differences among cognitive and symptom subtypes of schizophrenia SO JOURNAL OF NERVOUS AND MENTAL DISEASE LA English DT Article ID HETEROGENEITY; SUBSYNDROMES; DISORDER; TESTS C1 Univ Nevada, Dept Psychol, Las Vegas, NV 89154 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Rochester, Sch Med, Rochester, NY USA. Univ Pittsburgh, Pittsburgh, PA USA. Robert Wood Johnson Pharmaceut Res Inst, Raritan, NJ USA. RP Allen, DN (reprint author), Univ Nevada, Dept Psychol, 4505 Maryland Pkwy,Box 455030, Las Vegas, NV 89154 USA. FU NIMH NIH HHS [R01MH44-841] NR 26 TC 9 Z9 9 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-3018 J9 J NERV MENT DIS JI J. Nerv. Ment. Dis. PD JUN PY 2000 VL 188 IS 6 BP 381 EP 384 DI 10.1097/00005053-200006000-00010 PG 4 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 325QG UT WOS:000087687400010 PM 10890348 ER PT J AU Nettleton, JS Spain, WJ AF Nettleton, JS Spain, WJ TI Linear to supralinear summation of AMPA-mediated EPSPs in neocortical pyramidal neurons SO JOURNAL OF NEUROPHYSIOLOGY LA English DT Article ID EXCITATORY POSTSYNAPTIC POTENTIALS; DIFFERENTIAL SUBCELLULAR-LOCALIZATION; PERSISTENT SODIUM CONDUCTANCE; LAYER-V NEURONS; APICAL DENDRITES; CA2+ CHANNELS; HIPPOCAMPAL-NEURONS; TEMPORAL INTEGRATION; SYNAPTIC ACTIVATION; CALCIUM TRANSIENTS AB It has been hypothesized that voltage-sensitive conductances present on the dendrites of neurons can influence summation of excitatory postsynaptic potentials (EPSPs) and hence affect how neurons compile information. Greater than linear summation of EPSPs has been postulated to facilitate coincidence detection by cortical neurons. This study examined whether the summation of subthreshold AMPA-mediated EPSPs generated on layer V neocortical pyramidal neurons in vitro was linear and if any nonlinearities could be attributed to dendritic conductances. Evoked EPSPs (1-12 mV) were recorded somatically by means of intracellular sharp electrodes in the presence of 100 mu M amino-5-phosphonopentanoic acid (AP-5) and 3 mM bicuculline. Two independent EPSPs were evoked by a stimulating electrode in layer I and another in layers III-V. The areas of stimulation were isolated from each other by a horizontal cut below layer I. By subtracting the algebraic sum of the individual EPSPs from the evoked response when both EPSPs were evoked simultaneously, we determined that they summed linearly to supralinearly. Supralinear summation was more likely when the soma was hyperpolarized by DC current injection. Summation was predominantly linear when postsynaptic conductances (i.e., Na+ and Ca2+) were blocked with intracellular QX-314. The supralinear summation of EPSPs (without QX-314) decreased as the time between inputs was increased from 0 to 30 ms. To determine the role of dendrites in nonlinear summation, we substituted a current pulse (simulated EPSP) delivered at the soma for either or both of the evoked EPSPs. Simulated EPSPs combined with either an evoked EPSP or another simulated EPSP showed significantly less supralinear summation than two evoked EPSPs, indicating that the dendritic conductances were largely responsible for the observed supralinear summation. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Sch Med, Dept Physiol & Biophys, Seattle, WA 98195 USA. RP Spain, WJ (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. FU BLRD VA [I01 BX000386]; NIDDK NIH HHS [DK-02254]; NIGMS NIH HHS [GM-07108] NR 70 TC 47 Z9 47 U1 0 U2 7 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-3077 J9 J NEUROPHYSIOL JI J. Neurophysiol. PD JUN PY 2000 VL 83 IS 6 BP 3310 EP 3322 PG 13 WC Neurosciences; Physiology SC Neurosciences & Neurology; Physiology GA 323PK UT WOS:000087574000012 PM 10848551 ER PT J AU Hurley, RA Tomimoto, H Akiguchi, I Fisher, RE Taber, KH AF Hurley, RA Tomimoto, H Akiguchi, I Fisher, RE Taber, KH TI Binswanger's disease: An ongoing controversy SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article ID WHITE-MATTER LESIONS; MAGNETIZATION-TRANSFER RATIO; VASCULAR DEMENTIA; ALZHEIMERS-DISEASE; LEUKOARAIOSIS C1 Baylor Coll Med, Dept Radiol, Houston, TX 77030 USA. Baylor Coll Med, Dept Psychiat, Houston, TX 77030 USA. Baylor Coll Med, Dept Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Herbert J Frensley Ctr Imaging Res, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Psychiat & Radiol Serv, Houston, TX USA. Kyoto Univ, Dept Neurol, Sakyo Ku, Kyoto 606, Japan. RP Taber, KH (reprint author), Baylor Coll Med, Dept Radiol, 1 Baylor Plaza, Houston, TX 77030 USA. NR 25 TC 8 Z9 10 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD SUM PY 2000 VL 12 IS 3 BP 301 EP 304 DI 10.1176/appi.neuropsych.12.3.301 PG 4 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 343BX UT WOS:000088682800002 PM 10956563 ER PT J AU Kozel, FA Nahas, Z deBrux, C Molloy, M Lorberbaum, JP Bohning, D Risch, SC George, MS AF Kozel, FA Nahas, Z deBrux, C Molloy, M Lorberbaum, JP Bohning, D Risch, SC George, MS TI How coil-cortex distance relates to age, motor threshold, and antidepressant response to repetitive transcranial magnetic stimulation SO JOURNAL OF NEUROPSYCHIATRY AND CLINICAL NEUROSCIENCES LA English DT Article; Proceedings Paper CT 152nd Annual Meeting of the American-Psychiatric-Association CY MAY 15-20, 1999 CL WASHINGTON, D.C. SP Amer Psychiat Assoc ID DEPRESSION; TMS; MRI AB Repetitive transcranial magnetic stimulation (rTMS) is a fool with antidepressant potential that uses a coil placed on the scalp to produce a powerful magnetic field that directly stimulates only the outermost cortex. MRI scans weve obtained in 29 depressed adults involved in an rTMS antidepressant clinical treatment. These scans were analyzed to investigate the effect of distance from coil to cortex on clinical parameters. Longer motor cortex distance, but not prefrontal distance, strongly correlated with increased motor threshold (P < 0.01). Clinical antidepressant response did not correlate with either distance. The rTMS antidepressant responders, however, were significantly younger (t = -2.430, P < 0.05), and there appears to be a maximum threshold of age and distance to prefrontal cortex for response. C1 Med Univ S Carolina, Dept Psychiat, Brain Magnet Stimulat Labs, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Radiol, Brain Magnet Stimulat Labs, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Neurol, Brain Magnet Stimulat Labs, Charleston, SC 29425 USA. Med Univ S Carolina, Funct Neuroimaging Div, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Dept Psychiat, Charleston, SC USA. RP Kozel, FA (reprint author), Med Univ S Carolina, Dept Psychiat, Brain Magnet Stimulat Labs, 67 President St,POB 250861, Charleston, SC 29425 USA. RI Kozel, Frank/I-5366-2012 NR 23 TC 166 Z9 168 U1 1 U2 4 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 0895-0172 J9 J NEUROPSYCH CLIN N JI J. Neuropsychiatr. Clin. Neurosci. PD SUM PY 2000 VL 12 IS 3 BP 376 EP 384 DI 10.1176/appi.neuropsych.12.3.376 PG 9 WC Clinical Neurology; Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 343BX UT WOS:000088682800011 PM 10956572 ER PT J AU Fuhrman, L AF Fuhrman, L TI Common dermatoses of pregnancy SO JOURNAL OF PERINATAL & NEONATAL NURSING LA English DT Article DE dermatoses; hair changes; nail changes; physiological changes; pigment changes; pregnancy; pruritic; skin changes; structural changes; vascular changes ID PHYSIOLOGIC SKIN CHANGES; PSORIASIS; DISEASES; MELANOMA; WOMEN AB Awareness of pregnancy-related skin changes can facilitate improved care of women during pregnancy by identifying those skin changes that require further evaluation. Women experience significant endocrine and metabolic changes during pregnancy that can cause bath physiologic and pathologic alterations in the skin, nails, and hair. This review discusses the physiologic changes and pruritic dermatoses that are specifically associated with pregnancy. The effect of pregnancy on preexisting skin diseases and safe treatment options for usage during pregnancy will be provided. C1 San Francisco Vet Affairs Med Ctr, Dept Dermatol, San Francisco, CA 94121 USA. RP Fuhrman, L (reprint author), San Francisco Vet Affairs Med Ctr, Dept Dermatol, San Francisco, CA 94121 USA. NR 40 TC 0 Z9 0 U1 1 U2 2 PU ASPEN PUBL INC PI FREDERICK PA 7201 MCKINNEY CIRCLE, FREDERICK, MD 21704 USA SN 0893-2190 J9 J PERINAT NEONAT NUR JI J. Perinat. Neonatal Nurs. PD JUN PY 2000 VL 14 IS 1 BP 1 EP 16 PG 16 WC Nursing; Obstetrics & Gynecology; Pediatrics SC Nursing; Obstetrics & Gynecology; Pediatrics GA 321AG UT WOS:000087432300002 PM 11249290 ER PT J AU Martinez, V Rivier, J Coy, D Tache, Y AF Martinez, V Rivier, J Coy, D Tache, Y TI Intracisternal injection of somatostatin receptor 5-preferring agonists induces a vagal cholinergic stimulation of gastric emptying in rats SO JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS LA English DT Article ID CENTRAL-NERVOUS-SYSTEM; THYROTROPIN-RELEASING-HORMONE; HIGH-AFFINITY BINDING; DORSAL MOTOR NUCLEUS; ACID SECRETION; PARAVENTRICULAR NUCLEUS; MEDIATED INHIBITION; BARREL ROTATION; MESSENGER-RNA; SUBTYPE AB We previously showed that the somatostatin receptor 5 (sst(5))-preferring agonist BIM-23052 injected intracisternally (i.c.; 0.8 nmol/rat) stimulated gastric emptying of a non-nutrient meal in conscious rats. In this study, we investigated the neural pathways and specificity of BIM-23052 action. BIM-23052 (0.4, 0.8, and 1.2 nmol/rat i.c.) stimulated gastric transit; values of gastric emptying were 65.5 +/- 6.5, 77.4 +/- 5.3, and 77.7 +/- 1.9%, respectively, compared with 43.2 +/- 3.2% in i.c. saline group. Intravenous injection of BIM-23052 (0.8 nmol/rat) had no effect. BIM-23052 (0.8 nmol/rat i.c.) action was prevented by subdiaphragmatic vagotomy or atropine. Medullary thyrotropin-releasing hormone (TRH) is known to play a physiological role in the vagal stimulation of gastric motor function. TRH receptor antisense oligodeoxynucleotides injected i.c. with a regimen that prevented TRH (0.3 nmol/rat i.c.)-induced enhanced gastric emptying did not influence BIM-23052 stimulatory action. Somatostatin-28 (0.2-1.2 nmol/rat i.c.), which possesses a higher affinity than somatostatin-ld, for sst,, and the cyclic octapeptide des-AA(1,2,4,5,12,13)[D-Trp(8)]somatostatjn (0.2-1.2 nmol/rat i.c.), an oligo-somatostatin analog that shares similar brain actions as somatostatin-28, induced a dose-related stimulation of gastric emptying. Somatostatin-14 and the preferring peptide agonists for sst(1), CH-275; sst(2), DC-32-87; sst(3), BIM-23056 and L-796,778; and sst(4), L-803,087 had no significant effect on gastric emptying when injected i.c. at 0.8 nmol/rat. These results show that BIM-23056 injected i.c. acts in the brain independently from medullary TRH to induce a vagal cholinergic stimulation of gastric emptying through the sst(5) receptor subtype. C1 Univ Calif Los Angeles, Sch Med, VA Greater Los Angles Healthcare Syst, CURE Digest Dis Res Ctr,Dept Med,Digest Dis Div, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Brain Res Inst, Los Angeles, CA 90073 USA. Salk Inst Biol Studies, Clayton Fdn Labs Peptide Biol, La Jolla, CA 92037 USA. Tulane Univ, Med Ctr, Dept Med, Peptide Res Labs, New Orleans, LA 70112 USA. RP Tache, Y (reprint author), Univ Calif Los Angeles, Sch Med, VA Greater Los Angles Healthcare Syst, CURE Digest Dis Res Ctr,Dept Med,Digest Dis Div, Bldg 115,Room 203,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Martinez, Vicente/N-1189-2014 FU NIDDK NIH HHS [DK-50124, DK-33061, DK-41301] NR 44 TC 16 Z9 16 U1 0 U2 0 PU AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0022-3565 J9 J PHARMACOL EXP THER JI J. Pharmacol. Exp. Ther. PD JUN PY 2000 VL 293 IS 3 BP 1099 EP 1105 PG 7 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 323FR UT WOS:000087554800049 PM 10869415 ER PT J AU Kinosian, BP Stallard, E Lee, JH Woodbury, MA Zbrozek, AS Glick, HA AF Kinosian, BP Stallard, E Lee, JH Woodbury, MA Zbrozek, AS Glick, HA TI Predicting 10-year care requirements for older people with suspected Alzheimer's disease SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE Alzheimer's disease; epidemiology; economics; institutional care ID MENTAL STATUS QUESTIONNAIRE; NURSING-HOME; NATURAL-HISTORY; DEMENTIA; HEALTH; COSTS; TIME; INSTITUTIONALIZATION; PREVALENCE; COMMUNITY AB OBJECTIVE: To describe the types and costs of care received for 10 years after the identification of an older person with suspected Alzheimer's disease (AD) by using data from 3254 patients with suspected AD who participated in the National Long Term Care Survey (NLTCS). METHODS: By using a Markov model derived using grade of membership techniques, the following were determined: survival probabilities at 10 years; years of survival during the 10 years; years in institutions; years with two or more impairments in basic activities of daily living; hours of paid and informal care while the older person lived in the community; and costs of paid community, institutional, and medical care. RESULTS: Greater degrees of cognitive impairment present when AD was identified were associated with reduced predicted probability of surviving 10 years, increased predicted number of years spent in institutions, increased hours of care required while affected individuals remained in the community, and increased costs of paid community, institutional, and medical care. Substantial differences between men and women were seen: severity-adjusted 10-year costs were almost two times higher for women with AD than for men ($75,000 compared with $44,000); according to sensitivity analysis, average 10-year costs might be as high as $109,000 for women and $67,000 for men. CONCLUSIONS: AD imposes a substantial burden on older persons. Interventions that slow the progression of the disease may therefore affect community survival as well as healthcare costs. C1 Univ Penn, Div Gen Med, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Duke Univ, Ctr Demog Studies, Durham, NC 27706 USA. Bayer Corp, W Haven, CT USA. RP Glick, HA (reprint author), Univ Penn, Div Gen Med, 1211 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. NR 40 TC 30 Z9 30 U1 2 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUN PY 2000 VL 48 IS 6 BP 631 EP 638 PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 321YV UT WOS:000087483700005 PM 10855598 ER PT J AU Weaver, FM Hughes, SL Giobbie-Hurder, A Ulasevich, A Kubal, JD Fuller, J Kinosian, B Lichtenstein, MJ Rowe, J AF Weaver, FM Hughes, SL Giobbie-Hurder, A Ulasevich, A Kubal, JD Fuller, J Kinosian, B Lichtenstein, MJ Rowe, J TI The involvement of physicians in VA home care: Results from a national survey SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE home care; physicians; veterans ID HOUSE CALLS AB OBJECTIVES: To examine the role of physicians in the Veteran Affairs (VA) home-based primary care (HBPC) program and to identify variables that predict whether physicians make home visits and volume of home visits made. DESIGN: Descriptive and regression analyses of responses from a mail survey. PARTICIPANTS: Forty-five physicians affiliated with VA HBPC programs. MAIN SURVEY TOPICS: Self-reported work load, attitudes toward home care, reasons for home visits, administrative policies regarding physicians' role in patient care management, and time commitment to home care. RESULTS: A majority of physicians believed strongly in the importance of home care and made home visits for reasons consistent with their training. Physician attitude toward home care and preoccupation with office or hospital practice were related to whether or not physicians made home visits. Degree of preoccupation with office practice and amount of salary support from VA HBPC were significant predictors of the number of visits made (R-2 = 0.44). CONCLUSIONS: These findings indicate that most physicians will make home visits if they believe that home care is valuable and if their time commitment is supported financially. Managed care plans that own and operate home care programs and have the capacity to transfer primary care management to physicians who derive financial support from the programs should find this information particularly relevant. C1 Edward Hines Vet Adm Hosp, MCHSPR 151H, Hines, IL 60141 USA. Edward Hines Vet Adm Hosp, Cooperat Studies Ctr, Hines, IL 60141 USA. Edward Hines Vet Adm Hosp, VA Informat Resource Ctr, Hines, IL 60141 USA. Northwestern Univ, Inst Hlth Serv Res & Policy Studies, Evanston, IL USA. Univ Illinois, Sch Publ Hlth, Chicago, IL USA. Univ Illinois, Ctr Res Hlth & Aging, Chicago, IL USA. Prospect Associates, Silver Spring, MD USA. San Francisco VAMC, HBPC Program, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. VA Philadelphia Med Ctr, HBPC Program, Philadelphia, PA USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Geriatr Res & Clin Ctr, San Antonio, TX USA. Emory Univ, Sch Med, Decatur, GA 30033 USA. RP Weaver, FM (reprint author), Edward Hines Vet Adm Hosp, MCHSPR 151H, POB 5000, Hines, IL 60141 USA. NR 14 TC 1 Z9 1 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUN PY 2000 VL 48 IS 6 BP 677 EP 681 PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 321YV UT WOS:000087483700013 PM 10855606 ER PT J AU Hazzard, WR Currin, DL Woolard, N AF Hazzard, WR Currin, DL Woolard, N TI Revisiting the one-year geriatric fellowship option: A preliminary assessment SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE geriatric fellowship; 1-year training AB OBJECTIVE: To ascertain early opinions of geriatric fellowship program directors regarding the 1-year clinical training option. DESIGN: A brief mail survey of the 100 program directors listed in Graduate Medical Education, 1998-1999. MEASUREMENTS: Answers (favorable(+), no effect (0), or negative (-)) to questions regarding the effect on the training program, position of the director, and geriatrics as a discipline. RESULTS: This preliminary assessment produced decidedly mixed results. Seventy-six program directors responded (76% response rate). The dearest positive effect on the program itself was on the quantity of applicants (63% +, 4% -) but less so on their quality (33% +, 15% -). The dearest negative impact was on research aspects of the fellowship (0% +, 67%-). Other effects on the program were either null (clinical aspects and faculty morale) or moderately negative (educational, administrative, and financial aspects and the position of the program director), with few effects on the geriatrics division as a whole. Overall, the 1-year option was felt to have adversely affected geriatrics as a respected professional field (11% +, 41% -). Nevertheless, the majority (61%) answered that introduction of the 1-year option was wise. Although not attributed to this training pathway, program directors overwhelmingly perceived (75% +) that geriatrics has enjoyed enhanced strength and attractiveness as a discipline since introduction of the 1-year option in 1992. CONCLUSIONS: The 1-year geriatric fellowship option has, at best, proved a mixed blessing to program directors. However, optimism regarding the future would seem to justify continuing to offer this option because of several observations and trends: (1) the increase in quantity and also perhaps quality of applicants; (2) growth in numbers of fellows and higher percentage program fill rates; (3) success of both 1-and two-year fellows in passing the Certificate of Added Qualifications examination and consequent increased generation of certified fellowship-trained geriatricians; (4) strong sentiments that geriatrics is gaining strength and attractiveness and (5) that introduction of the 1-year option was wise. C1 Wake Forest Univ, Sch Med, J Paul Sticht Ctr Aging, Winston Salem, NC 27109 USA. RP Hazzard, WR (reprint author), VA Puget Sound Hlth Care Syst, Geriatr & Extended Care S182 GEC, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 4 TC 11 Z9 11 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUN PY 2000 VL 48 IS 6 BP 686 EP 690 PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 321YV UT WOS:000087483700015 PM 10855608 ER PT J AU Ratcliffe, MB Wallace, AW Teerlink, JR Hong, J Salahieh, A Sung, SH Keung, EC Lee, RJ AF Ratcliffe, MB Wallace, AW Teerlink, JR Hong, J Salahieh, A Sung, SH Keung, EC Lee, RJ TI Radio frequency heating of chronic ovine infarct leads to sustained infarct area and ventricular volume reduction SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article; Proceedings Paper CT 25th Annual meeting of the Western-Thoracic-Surgical-Association CY JUN 23-26, 1999 CL LAKE TAHOE, CALIFORNIA SP Western Thorac Surg Assoc ID MYOCARDIAL-INFARCTION; COLLAGENOUS TISSUE; HEART-FAILURE; MECHANICS; SHRINKAGE; ANEURYSM; SURVIVAL; DYSFUNCTION; MORTALITY; EXERCISE AB Objective: Myocardial infarct expansion and subsequent left ventricular remodeling are associated with increased incidence of congestive failure and mortality. Collagen is known to denature and contract when heated above 65 degrees C. We therefore tested the hypothesis that radio frequency heating of myocardial infarct tissue with application of a restraining patch causes a sustained reduction in myocardial infarct area and left ventricular volume. Methods: Thirteen male Dorset sheep underwent surgical coronary artery ligation. At least 14 weeks later, animals were randomized to either radio frequency infarct heating (95 degrees C) with application of a restraining patch or a sham operation. Before treatment, after treatment, and 10 weeks later, left ventricular volume was measured with transdiaphragmatic echocardiography and myocardial infarct area was measured with an array of sonomicrometry crystals. Results: Radio frequency infarct heating causes an acute decrease of 34% (-215 +/- 82 mm(2); P = .0002) in infarct area at end-diastole that is maintained at 10 weeks (-144 +/- 79 mm(2); P = .0002). Radio frequency infarct heating causes a downward trend in end-diastolic left ventricular volume measured by echocardiography of 20% (-15.7 +/- 6.3 mt; P = no significant difference) and end-systolic left ventricular volume of 32% (-17.1 +/- 9.8 mt; P = .09), which are significantly decreased at 10 weeks (-13.6 +/- 22.3 mt; P = .007 and -15.3 +/- 21.9 mt; P = .008, respectively). Radio frequency infarct heating causes an acute improvement in systolic function (P < .001), a sustained increase in left ventricular ejection fraction (+0.11%; P = .06), and preserved stroke volume. Conclusion: Radio frequency heating of chronic left ventricular myocardial infarct causes a sustained reduction in infarct area and left ventricular volume. This technique may beneficially reverse infarct expansion and left ventricular remodeling after myocardial infarction. C1 San Francisco Vet Affairs Med Ctr, VAMC Surg 112D, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Med, Div Cardiothorac Surg, Dept Surg, San Francisco, CA 94143 USA. Univ Calif San Francisco, Sch Med, Dept Anesthesia, San Francisco, CA 94143 USA. Univ Calif San Francisco, Sch Med, Div Cardiol, San Francisco, CA 94143 USA. RP Ratcliffe, MB (reprint author), San Francisco Vet Affairs Med Ctr, VAMC Surg 112D, 4150 Clement St, San Francisco, CA 94121 USA. RI Teerlink, John/D-2986-2012 NR 32 TC 8 Z9 8 U1 0 U2 1 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0022-5223 J9 J THORAC CARDIOV SUR JI J. Thorac. Cardiovasc. Surg. PD JUN PY 2000 VL 119 IS 6 BP 1194 EP 1204 DI 10.1067/mtc.2000.105826 PG 11 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 323HR UT WOS:000087560400018 PM 10838539 ER PT J AU Rubenstein, LZ Josephson, KR Trueblood, PR Loy, S Harker, JO Pietruszka, FM Robbins, AS AF Rubenstein, LZ Josephson, KR Trueblood, PR Loy, S Harker, JO Pietruszka, FM Robbins, AS TI Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID RANDOMIZED CONTROLLED TRIAL; OLDER ADULTS; TAI-CHI; BALANCE; COMMUNITY; GAIT; PERFORMANCE; WOMEN; INTERVENTION; DISABILITY AB Objectives. This randomized controlled trial studied the effects of a low- to moderate-intensity group exercise program on strength, endurance, mobility, and fall rates in fall-prone elderly men with chronic impairments. Methods. Fifty-nine community-living men (mean age = 74 years) with specific fall risk factors (i.e., leg weakness, impaired gait or balance, previous falls) were randomly assigned to a control group (n = 28) or to a 12-week group exercise program (n = 31). Exercise sessions (90 minutes, three times per week) focused on increasing strength and endurance and improving mobility and balance. Outcome measures included isokinetic strength and endurance, five physical performance measures, and self-reported physical functioning, health perception, activity level, and falls. Results. Exercisers showed significant improvement in measures of endurance and gait. Isokinetic endurance increased 21% for right knee flexion and 26% for extension. Exercisers had a 10% increase (p < .05) in distance walked in six minutes, and improved (p < .05) scores on an observational gait scale. Isokinetic strength improved only for right knee flexion. Exercise achieved no significant effect on hip or ankle strength, balance, self-reported physical Functioning, or number of falls. Activity level increased within the exercise group. When fall rates were adjusted for activity level, the exercisers had a lower 3-month fall rate than controls (6 falls/1000 hours of activity vs 16.2 fails/1000 hours, p < .05). Discussion. These findings suggest that exercise can improve endurance, strength, gait, and function in chronically impaired, fall-prone elderly persons. In addition, increased physical activity was associated with reduced fall rates when adjusted for level of activity. C1 VA Greater Los Angeles Healthcare Syst, Geriatr Res Educ & Clin Ctr 11E, Sepulveda, CA 91343 USA. Calif State Univ Fresno, Dept Phys Therapy, Fresno, CA 93740 USA. Calif State Univ Northridge, Dept Kinesiol, Northridge, CA 91330 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Rubenstein, LZ (reprint author), VA Greater Los Angeles Healthcare Syst, Geriatr Res Educ & Clin Ctr 11E, 16111 Plummer St, Sepulveda, CA 91343 USA. NR 26 TC 186 Z9 191 U1 11 U2 37 PU GERONTOLOGICAL SOCIETY AMER PI WASHINGTON PA 1275 K STREET NW SUITE 350, WASHINGTON, DC 20005-4006 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD JUN PY 2000 VL 55 IS 6 BP M317 EP M321 PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 331XV UT WOS:000088044700011 PM 10843351 ER PT J AU Johansen, KL Chertow, GM Ng, AV Mulligan, K Carey, S Schoenfeld, PY Kent-Braun, JA AF Johansen, KL Chertow, GM Ng, AV Mulligan, K Carey, S Schoenfeld, PY Kent-Braun, JA TI Physical activity levels in patients on hemodialysis and healthy sedentary controls SO KIDNEY INTERNATIONAL LA English DT Article; Proceedings Paper CT 32nd Annual Meeting of the American-Society-of-Nephrology CY NOV 02-05, 1999 CL MIAMI, FLORIDA SP Amer Soc Nephrol DE end-stage renal disease; exercise; mortality and physical inactivity; dialysis; nutrition; uremic muscle ID RECOMBINANT-HUMAN-ERYTHROPOIETIN; MULTIPLE-SCLEROSIS; EXERCISE CAPACITY; ACCELEROMETER; DIALYSIS; QUALITY; RECALL; LIFE AB Background. Patients on dialysis have reduced exercise tolerance compared with age-matched sedentary controls. The reasons for this debility have not been fully elucidated, but physical inactivity could be a contributing factor. The purpose of the current study was to determine whether patients on hemodialysis are less active than healthy sedentary controls and to explore clinical correlates of physical activity level in a group of hemodialysis patients. Methods. Thirty-four hemodialysis patients and 80 healthy sedentary individuals participated in the study. Physical activity was measured for seven days with a three-dimensional accelerometer and with an activity questionnaire. Results. Vector magnitude values from the accelerometer for the dialysis and control subjects were 104,718 +/- 9631 and 161,255 +/- 6792 arbitrary units per day, respectively (P < 0.0001, mean +/- SEM). The estimated energy expenditure values derived from the questionnaire were 33.6 +/- 0.5 kcal/kg/day and 36.2 +/- 0.5 kcal/kg/day (P = 0.002). The difference between patients on dialysis and controls increased with advancing age. Among the dialysis subjects, some measures of nutritional status correlated with physical activity level, including serum albumin concentration (r = 0.58, P = 0.003), serum creatinine concentration (r = 0.37, P = 0.03), and phase angle derived from bioelectrical impedance analysis (r = 0.40, P = 0.02). Conclusions. Patients on hemodialysis are less active than healthy sedentary controls, and this difference is more pronounced among older individuals. There is an association between the level of physical activity and nutritional status among patients on dialysis. These findings are of great concern, given the trend toward increasing age in incident dialysis patients and the well-known association between inactivity and increased mortality in the general population. C1 Univ Calif San Francisco, Moffitt Long Hosp, San Francisco VA Med Ctr, Div Nephrol, San Francisco, CA USA. Univ Calif San Francisco, UCSF Mt Zion Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco Gen Hosp, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, San Francisco Gen Hosp, Dept Radiol, San Francisco, CA USA. Univ Calif San Francisco, San Francisco Gen Hosp, Dept Physiol Nursing, San Francisco, CA USA. RP Johansen, KL (reprint author), San Francisco VA Med Ctr, Div Nephrol 111J, 4150 Clement St, San Francisco, CA 94121 USA. FU NCRR NIH HHS [RR00083] NR 29 TC 193 Z9 198 U1 3 U2 15 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD JUN PY 2000 VL 57 IS 6 BP 2564 EP 2570 DI 10.1046/j.1523-1755.2000.00116.x PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 319MQ UT WOS:000087346100038 PM 10844626 ER PT J AU Ashton, CM Bozkurt, B Colucci, WB Kiefe, CI Mann, DL Massie, BM Slawsky, MT Tierney, WM West, JA Whellan, DJ Wray, NP AF Ashton, CM Bozkurt, B Colucci, WB Kiefe, CI Mann, DL Massie, BM Slawsky, MT Tierney, WM West, JA Whellan, DJ Wray, NP TI Veterans affairs quality enhancement research initiative in chronic heart failure SO MEDICAL CARE LA English DT Article DE chronic heart failure; quality of care; Veterans Affairs ID CONVERTING ENZYME-INHIBITORS; PRACTICE GUIDELINES; ELDERLY PATIENTS; EARLY READMISSION; CARE; MANAGEMENT; LIFE; PATTERNS; OUTCOMES; EDUCATION AB Chronic heart failure (CHF) is a highly prevalent condition associated with serious morbidity, intense levels of health services use, and shortened survival. It is also a condition for which ameliorative therapies exist. The evidence indicates that there is substantial need to change clinical practice and health care delivery for people with CHF and thereby improve their outcomes. The goal of the Veterans Affairs (VA) Quality Enhancement Research Initiative in CHF (CHF QUERI) is to create measurable, rapid, and sustainable improvements in quality of care and health outcomes of veterans with heart failure. This article describes the current state of knowledge and practice in fare for people with CHF. Using the framework of the 5 steps of the QUERI process, we point out the gaps in research and practice that must be filled if the CHF QUERI is to achieve its goal. We relate our recommendations for how the VA can put its research and administrative infrastructure to work to fill the gaps. Lessons learned about CHF in the course of the CHF QUERI will be applicable to all people with heart failure and to all health care systems-VA as well as non-VA-that care for them. C1 VA Med Ctr 152, Houston, TX 77030 USA. VA Ctr Excellence Hlth Serv Res, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Vet Affairs Med Ctr, Boston, MA USA. Vet Affairs Med Ctr, Birmingham, AL USA. Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Vet Affairs Med Ctr, Indianapolis, IN USA. Vet Affairs Med Ctr, Palo Alto, CA 94304 USA. Vet Affairs Med Ctr, Durham, NC 27705 USA. RP Ashton, CM (reprint author), VA Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM cashton@bcm.tmc.edu NR 56 TC 2 Z9 2 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 EI 1537-1948 J9 MED CARE JI Med. Care PD JUN PY 2000 VL 38 IS 6 SU VA1 BP S26 EP S37 PG 12 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 321NV UT WOS:000087462300004 ER PT J AU Bozzette, SA Phillips, B Asch, S Gifford, AL Lenert, L Menke, T Ortiz, E Owens, D Deyton, L AF Bozzette, SA Phillips, B Asch, S Gifford, AL Lenert, L Menke, T Ortiz, E Owens, D Deyton, L CA HIV-QUERI Executive Comm TI Quality enhancement research initiative for human immunodeficiency virus/acquired immunodeficiency syndrome - Framework and plan SO MEDICAL CARE LA English DT Article DE quality of health care; delivery of health care; acquired immunodeficiency syndrome; human immunodeficiency virus infections ID HIV-INFECTED ADULTS; UNITED-STATES; THERAPY; CARE; MEDICATIONS; SERVICES; DISEASE; COST AB The Veterans Health Administration (VHA) sees approximate to 17,000 human immunodeficiency virus (HIV)-infected patients each year, which makes it the largest provider of HIV care in the United States. HIV causes chronic progressive disease that leads to early death. Newer combination antiretroviral treatments are effective but expensive and difficult to use. The HIV Quality Enhancement Research Initiative (HIV-QUERI) uses the QUERI process to identify high-risk and high-volume populations (step 1), which includes those already under MFA care for HIV, those who do not know of their infection, and those at risk for HIV. In identifying best practices (step 2), the HIV-QUERI will benefit greatly from existing guidelines for the care of established HIV infection, but gaps in knowledge regarding adherence to medication regimens and cost-effective screening are large. To identify existing practice patterns (step 3), the HIV-QUERI will develop a clean analytic data set based on Immunology Case Registry files and expand it through a survey of veterans. Interventions to improve care (step 4) will include national, regional, and site-specific feedback on performance relative to quality standards, as well as patient-level and provider-level interventions to improve adherence and support medical decision-making. To document that best practices improve outcomes and quality of Life (steps 5 and 6), HIN-QUERI will track indicators on an ongoing basis by use of the Immunology Case Registry database and possible future waves of the survey. In addition, we will require that these issues be addressed in evaluations of HIV-QUERI interventions. In the present article, we present these steps within a framework and plan. C1 UCSD, VASDHS, Hlth Serv Res & Dev Unit, San Diego, CA USA. RAND Hlth, Santa Monica, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Vet Affairs Houston Healthcare Syst, Houston, TX USA. Baylor Univ, Houston, TX 77030 USA. Vet Affairs Palo Alto Healthcare Syst, Palo Alto, CA USA. Stanford Univ, Palo Alto, CA 94304 USA. Vet Hlth Adm, AIDS Serv, Washington, DC USA. RP Bozzette, SA (reprint author), UCSD, VASDHS, Hlth Serv Res & Dev Unit, Mail Code 111N1,3350 La Jolla Village Dr, San Diego, CA USA. NR 16 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JUN PY 2000 VL 38 IS 6 SU VA1 BP S60 EP S69 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 321NV UT WOS:000087462300007 ER PT J AU Every, NR Fihn, SD Sales, AEB Keane, A Ritchie, JR AF Every, NR Fihn, SD Sales, AEB Keane, A Ritchie, JR CA QUERI IHD Executive Comm TI Quality enhancement research initiative in ischemic heart disease - A quality initiative from the Department of Veterans Affairs SO MEDICAL CARE LA English DT Article DE ischemic heart disease; guidelines; quality of care ID ACUTE MYOCARDIAL-INFARCTION; UNSTABLE ANGINA; PHYSICIAN PERFORMANCE; THROMBOLYTIC THERAPY; CONTROLLED TRIAL; ELDERLY PATIENTS; CARE; ASPIRIN; GUIDELINES; MORTALITY AB Despite the dramatic fall in ischemic heart disease (IHD) mortality rates over the last 3 decades, it remains the number one cause of death in the United States, and one of the most frequent indications for care by the US Department of Veterans Affairs. National practice guidelines have been developed and disseminated both by societies that specialize in cardiology and within the Veterans Health Administration. Despite these efforts, a substantial minority remains of patients with IHD who are not treated with guideline-recommended therapies. The Quality Enhancement Research Initiative in IHD is a Veterans Health Administration-sponsored initiative to address the gap between guideline-recommended therapies and actual Department of Veterans Affairs practice. Because guideline development for patients with IHD is relatively mature, the Quality Enhancement Research Initiative in Ii-ID will concentrate on measuring existing practices, implementing interventions, and evaluating outcomes in veterans with IHD. Measurement of existing practices will be evaluated through analyses of existing Veterans Affairs databases developed for the Continuous Improvement in Cardiac Surgery Program, as well as data collected at the Center for the Study of Practice Patterns in veterans with acute myocardial infarction. To measure existing practices in outpatients with IHD, we plan to develop a new database that extracts electronic data from patient laboratory and pharmacy records into a relational database. Interventions to address gaps between guideline recommendations and actual practice will be solicited and implemented at individual medical centers. We plan to emphasize point-of-care electronic reminders as well as online decision support as methods for improving guideline compliance. C1 VA Puget Sound Hlth Care Syst, NW Hlth Serv Res, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Dev Field Program, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv Res, Seattle, WA 98195 USA. RP Every, NR (reprint author), VA Puget Sound Hlth Care Syst, NW Hlth Serv Res, 1660 S Columbian Way, Seattle, WA 98108 USA. NR 49 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JUN PY 2000 VL 38 IS 6 SU VA1 BP S49 EP S59 PG 11 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 321NV UT WOS:000087462300006 ER PT J AU Fischer, EP Marder, SR Smith, GR Owen, RR Rubenstein, L Hedrick, SC Curran, GM AF Fischer, EP Marder, SR Smith, GR Owen, RR Rubenstein, L Hedrick, SC Curran, GM TI Quality enhancement research initiative in mental health SO MEDICAL CARE LA English DT Article DE major depressive disorder; schizophrenia; quality of care; physician practice patterns; practice guidelines; patient compliance; QUERI ID EPIDEMIOLOGIC CATCHMENT-AREA; PRIMARY-CARE PRACTICE; TREATING MAJOR DEPRESSION; UNITED-STATES; ANTIDEPRESSANT MEDICATIONS; SUBSTANCE-ABUSE; HIGH UTILIZERS; DISORDERS; OUTCOMES; SCHIZOPHRENIA AB The Veterans Administration (VA) recently introduced its Quality Enhancement Research Initiative (QUERI) to facilitate the translation of best practices into usual clinical fare. The Mental Health QUERI (MHQ) was charged with developing strategic plans for major depressive disorder (MDD) and schizophrenia. Twenty percent or more of VA service users are affected by 1 of these 2 disorders, disorders that often have a devastating impact on affected individuals. Despite the increasing availability of efficacious treatments for each disorder, substantial gaps remain between best practices and routine care. In this context, the MHQ identified steps critical to the success of a sustained process of rapid-cycle health care improvement for MDD and schizophrenia, including research initiatives to close gaps in knowledge of best treatment practices, demonstration projects to close gaps in practice and to expand understanding of effective strategies for implementing clinical guidelines, targeted enhancements of the VA information system, and research and dissemination initiatives to increase the availability of resources to support the accelerated incorporation of best practices into routine care. This article presents an overview of the elements in the initial MHQ strategic plans and the rationale behind them. C1 Cent Arkansas Vet Healthcare Syst, HSR&D Mental Hlth QUERI, VA HSR&D Ctr Mental Healthcare & Outcomes Res, N Little Rock, AR 72114 USA. Univ Arkansas Med Sci, Dept Psychiat & Behav Sci, Little Rock, AR 72205 USA. W Los Angeles VA Med Ctr, Mental Illness Res Educ & Clin Ctr 22, VISN, Los Angeles, CA USA. Univ Arkansas Med Sci, Dept Psychiat, Little Rock, AR 72205 USA. Univ Arkansas Med Sci, Dept Behav Sci, Little Rock, AR 72205 USA. Univ Arkansas Med Sci, Dept Med, Little Rock, AR 72205 USA. Sepulveda VAMC, VA HSR&D Ctr Study Healthcare Provider Behav, Sepulveda, CA USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA USA. VA Puget Sound Hlth Care Syst, VA HSR&D Ctr Outcomes Res Older Adults, Seattle, WA USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. RP Fischer, EP (reprint author), Cent Arkansas Vet Healthcare Syst, HSR&D Mental Hlth QUERI, VA HSR&D Ctr Mental Healthcare & Outcomes Res, 2200 Ft Roots Dr 152-NLR, N Little Rock, AR 72114 USA. NR 78 TC 1 Z9 1 U1 2 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JUN PY 2000 VL 38 IS 6 SU VA1 BP S70 EP S81 PG 12 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 321NV UT WOS:000087462300008 ER PT J AU Rubenstein, LV Mittman, BS Yano, EM Mulrow, CD AF Rubenstein, LV Mittman, BS Yano, EM Mulrow, CD TI From understanding health care provider behavior to improving health care - The QUERI framework for quality improvement SO MEDICAL CARE LA English DT Article DE physicians; quality of patient care; outcomes and process assessment ID PRACTICE GUIDELINES; SYSTEMATIC REVIEWS; CLINICAL DECISIONS; IMPACT; TRIAL; IMPLEMENTATION; DISSEMINATION; PERFORMANCE; MANAGEMENT; MEDICINE AB Basic science and health care research provide the evidence base for the scientific practice of medicine. Over the past 2 decades, as increasingly refined tools for improving health and health care have been developed, the health care community has attempted to bridge the gap between available tools and actual health care practices. This gap can be bridged only by influencing health care provider behavior. The VA Quality Enhancement Research Initiative (QUERI) is a program designed to systematically translate research findings into better health care practices, and thus better health outcomes for enrolled veterans. Integrating provider behavior research considerations and findings into each step of the QUERI process will enhance the effectiveness of the initiative. This article presents a provider behavior research framework for planning, implementing, and evaluating quality improvement interventions within QUERI. C1 VA Ctr Study Healthcare Provider Behav 152, HSR&D Ctr Excellence, Sepulveda Ambulatory & Nursing Home Ctr, VA Greater Los Angeles Healthcare Syst, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Audie Murphy VA Med Ctr, VA Cochrane Ctr, San Antonio, TX USA. RP Rubenstein, LV (reprint author), VA Ctr Study Healthcare Provider Behav 152, HSR&D Ctr Excellence, Sepulveda Ambulatory & Nursing Home Ctr, VA Greater Los Angeles Healthcare Syst, 16111 Plummer St, Sepulveda, CA 91343 USA. NR 54 TC 8 Z9 8 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD JUN PY 2000 VL 38 IS 6 SU VA1 BP S129 EP S141 PG 13 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 321NV UT WOS:000087462300013 ER PT J AU Restrepo, MI Najvar, LK Barchiesi, F Luther, MF Graybill, JR AF Restrepo, MI Najvar, LK Barchiesi, F Luther, MF Graybill, JR TI Treatment of murine cryptococcal meningitis with UR-9751 and UR-9746 SO MEDICAL MYCOLOGY LA English DT Article DE fluconazole; murine cryptococcal meningitis ID AMPHOTERICIN-B AB In these studies, we compare the efficacy of two new azole antifungals with fluconazole in a murine model of cryptococcal meningitis. Mice were infected intracranially. Beginning one day later, groups of 7-10 mice were treated through to day 10 orally with UR-9751 or UR-9746 at 0.1, 0.25, 0.5, 1 or 10 mg kg(-1) day(-1) or fluconazole at 10 mg kg(-1) day(-1). At 10 mg kg(-1) day(-1), all three drugs prolonged survival over controls, but at 1 mg kg(-1) day(-1), only UR-9746 prolonged survival. Tissue counts were more varied on mice sacrificed 8 days after infection. In general, both UR drugs were equal or more potent than fluconazole, and UR-9751 was more effective than UR-9746. C1 Audie L Murphy Mem Vet Hosp, Dept Med 111F, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78284 USA. RP Graybill, JR (reprint author), Audie L Murphy Mem Vet Hosp, Dept Med 111F, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. NR 11 TC 1 Z9 1 U1 0 U2 0 PU B I O S SCIENTIFIC PUBLISHERS LTD PI OXFORD PA 9 NEWTEC PLACE, MAGDALEN RD, OXFORD OX4 1RE, ENGLAND SN 1369-3786 J9 MED MYCOL JI Med. Mycol. PD JUN PY 2000 VL 38 IS 3 BP 221 EP 224 PG 4 WC Infectious Diseases; Mycology; Veterinary Sciences SC Infectious Diseases; Mycology; Veterinary Sciences GA 329PV UT WOS:000087916900006 PM 10892990 ER PT J AU Fitzgerald, SG Morgenstern, E AF Fitzgerald, SG Morgenstern, E TI Global improvement in intellectual and neuropsychological functioning after removal of a suprasellar cystic craniopharyngioma SO MILITARY MEDICINE LA English DT Article ID INTELLIGENCE; ADULTS; WAIS AB This is a case report of a patient who presented with cognitive and behavioral decline and underwent surgery for removal of a suprasellar craniopharyngioma, Previous studies have reported memory impairments in the presence of craniopharyngioma, but information is lacking regarding the impact of craniopharyngioma on other brain functions as well as on intellectual abilities. In this study, comprehensive neuropsychological testing, including intellectual testing, was conducted 9 to 14 days before surgery and 16 to 22 days after surgery. Results before surgery demonstrated average intellectual abilities, which were decreased from premorbid estimates, and diffuse neuropsychological impairments. Postoperatively, significant improvement in both intellectual abilities and neuropsychological test scores was observed. These results suggest that craniopharyngiomas can be associated with impairments in intellectual abilities and in brain functions aside from memory. The results are contrasted with those of previous reports, and implications for future research are discussed. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Fitzgerald, SG (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. NR 23 TC 2 Z9 2 U1 0 U2 0 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD JUN PY 2000 VL 165 IS 6 BP 496 EP 499 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 324RG UT WOS:000087634700018 PM 10870373 ER PT J AU Nishimura, RN Santos, D Fu, ST Dwyer, BE AF Nishimura, RN Santos, D Fu, ST Dwyer, BE TI Induction of cell death by L-alpha-aminoadipic acid exposure in cultured rat astrocytes: Relationship to protein synthesis SO NEUROTOXICOLOGY LA English DT Article DE astrocytes; cell death; L-alpha-aminoadipic acid; protein synthesis; heat shock proteins ID HEAT-SHOCK PROTEIN-70; LONG-TERM OBSERVATION; LYSINE METABOLISM; CORTICAL-NEURONS; HEME OXYGENASE; KAINIC ACID; AMINO-ACIDS; CARP RETINA; GLIAL-CELLS; BRAIN AB The excitotoxin, L-alpha-aminoadipic acid (L-AAA), kills primary astrocytes in the brain. The mechanism underlying the induction of cell death is not well understood although many possible mechanisms are theorized. Previous studies have reported that astrocytes die after prolonged exposure to L-AAA suggesting a delayed programmed cell death and apoptosis. In this study rat cortical astrocytes exposed to continuous 1 mM L-AAA exposure for 24-, 48-, or 72 hours demonstrated increased DNA laddering, a characteristic of apoptosis. Unexpectedly, this was not ameliorated by the presence of cycloheximide at 0.1 mu g/ml medium. Because of our interest in cytoprotective heat shock proteins induced by excitoxic stress, we studied the effect of prolonged exposure of L-AAA on the synthesis of stress proteins and protein synthesis in rat cortical astrocytes. Protein synthesis as measured by [S-35]-methionine labeling showed a marked and significant decrease in incorporation of radiolabel after 24 hours of exposure to L-AAA and prior to induction of significant cell death noted at 48- and 72 hours of L-AAA exposure. The inhibition of protein synthesis was partially reversible at 24 hours if cells were labeled in medium without L-AAA during the radiolabeling period. Heat shock or stress proteins, HSP70 and heme oxygenase-1 (HO-1), were analyzed after a 24 hour exposure to L-AAA and showed no significant induction of HSP70 or HO-1. The findings suggest that the prolonged inhibition of protein synthesis and associated lack of induction of HSP70 and HO-1 synthesis contributed to apoptotic cell death induced by the excitoxin L-AAA. (C) 2000 Intox Press, Inc. C1 VA Greater Los Angeles Healthcare Syst, Sepulveda ACCNH, Dept Neurol, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Los Angeles, CA 90095 USA. Vet Adm Hosp, White River Junction, VT 05009 USA. ROC, Res Serv 151, White River Junction, VT 05009 USA. RP Nishimura, RN (reprint author), VA Greater Los Angeles Healthcare Syst, Sepulveda ACCNH, Dept Neurol, 111N-1,16111 Plummer St, Sepulveda, CA 91343 USA. NR 32 TC 12 Z9 12 U1 0 U2 0 PU INTOX PRESS INC PI LITTLE ROCK PA PO BOX 24865, LITTLE ROCK, AR 72221 USA SN 0161-813X J9 NEUROTOXICOLOGY JI Neurotoxicology PD JUN PY 2000 VL 21 IS 3 BP 313 EP 320 PG 8 WC Neurosciences; Pharmacology & Pharmacy; Toxicology SC Neurosciences & Neurology; Pharmacology & Pharmacy; Toxicology GA 329AG UT WOS:000087883500006 PM 10894121 ER PT J AU Hynes, DM AF Hynes, DM TI Research as a key to promoting and sustaining innovative practice SO NURSING CLINICS OF NORTH AMERICA LA English DT Article ID EVIDENCE-BASED MEDICINE; QUALITY IMPROVEMENT; CARE AB During the past decade, we have witnessed increasing emphasis on the integration of research and clinical care with the evolution of evidence-based practice and best practices. The principles underlying evidence-based medicine and best practices are fundamental to understanding the interdependence of research and innovation. These principles helped guide the US Department of Veterans Affairs (VA) Nursing innovations Task Force to review and critique programs at VA health care facilities across the United States. This article reviews how the task force applied concepts and principles of evidence-based practice to identify innovative practices at VA health care facilities. Also described are task force recommendations to foster innovative practice through increased nursing research capacity, and strategies are suggested for applying these principles in other health care settings. C1 Dept Vet Affairs Innovat Nursing Initiat Review T, Hines, IL USA. Vet Affairs Informat Resource Ctr, Hlth Serv Res & Dev Serv Special Resource Ctr, Hines, IL USA. Midw Ctr Hlth Serv Res, Hines, IL USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Cooperat Studies Program Coordinating Ctr, Hines, IL 60141 USA. Loyola Univ, Dept Med, Div Gen Internal Med, Maywood, IL 60153 USA. RP Hynes, DM (reprint author), Edward Hines Vet Adm Hosp, VA Informat Resource Ctr 151V, 5th Ave & Rossevelt Rd,Bldg 1,Room B260, Hines, IL 60141 USA. NR 15 TC 0 Z9 0 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0029-6465 J9 NURS CLIN N AM JI Nurs. Clin. North Am. PD JUN PY 2000 VL 35 IS 2 BP 453 EP + PG 9 WC Nursing SC Nursing GA 329RB UT WOS:000087920700017 PM 10873257 ER PT J AU Hemphill, L Kemp, J AF Hemphill, L Kemp, J TI Implementing a therapeutic massage program in a tertiary and ambulatory care va setting - The healing power of touch SO NURSING CLINICS OF NORTH AMERICA LA English DT Article AB The ancient practice of massage to promote healing has a plate in contemporary health care. This article discusses the implementation of a nurse-run therapeutic massage service at the Denver Veterans Administration Medical Center. program background, evaluation, future plans, and lessons learned are described. C1 Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. RP Hemphill, L (reprint author), Denver Vet Affairs Med Ctr, 1055 Clermont, Denver, CO 80220 USA. NR 24 TC 4 Z9 4 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0029-6465 J9 NURS CLIN N AM JI Nurs. Clin. North Am. PD JUN PY 2000 VL 35 IS 2 BP 489 EP + PG 10 WC Nursing SC Nursing GA 329RB UT WOS:000087920700021 PM 10873261 ER PT J AU Schwartz, F Genovese, L Devitt, K Gottlieb, T AF Schwartz, F Genovese, L Devitt, K Gottlieb, T TI Multisite regional telephone care SO NURSING CLINICS OF NORTH AMERICA LA English DT Article AB A multisite, regional telephone-care program staffed by advance practice and critical care nurses has improved patient care and reduced unnecessary clinic and emergency room visits. It allows patients to access the health care system and receive expert advice through the use of the telephone, 24 hours per day, 7 days per week. Computerized patient medical records from eight hospitals and 31 clinics are available to a registered nurse so that informed decisions can be made. The RN records the patient's concern and intervention directly into the patient's medical record, which is transmitted to the primary care provider in real time. C1 Bronx Vet Affairs Med Ctr, Network Telephone Care Program, Bronx, NY 10468 USA. Hudson Valley Hlth Care Syst, Montrose, NY USA. Bronx Vet Affairs Med Ctr, Med Surg Patient Care Ctr, Bronx, NY 10468 USA. RP Schwartz, F (reprint author), Bronx Vet Affairs Med Ctr, Network Telephone Care Program, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. NR 17 TC 5 Z9 5 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0029-6465 J9 NURS CLIN N AM JI Nurs. Clin. North Am. PD JUN PY 2000 VL 35 IS 2 BP 527 EP + PG 14 WC Nursing SC Nursing GA 329RB UT WOS:000087920700025 PM 10873265 ER PT J AU Chow, MT Anderson, SF AF Chow, MT Anderson, SF TI Relapsing polychondritis SO OPTOMETRY AND VISION SCIENCE LA English DT Article DE ocular inflammation; orbital cellulitis; orbital pseudotumor; polychondropathy; posterior scleritis; relapsing polychondritis; thyroid eye disease; HLA-DR4 ID DISEASE; COMPLICATIONS; INVOLVEMENT; CARTILAGE; ARTHRITIS AB Background: Relapsing polychondritis (RPC) is a rare, chronic, and potentially fatal multisystemic inflammatory disorder targeting cartilaginous structures. This disorder is frequently associated with rheumatoid arthritis, systemic vasculitis, connective tissue diseases, and/or hematologic disorders. RPC afflicts patients with recurrent and often progressive episodes of inflammation with the potential for destruction of the affected structures. Tissues involved include the ears, joints, nose, larynx, trachea, eyes, heart valves, kidneys,and skin. Ocular manifestations commonly include episcleritis, scleritis, conjunctivitis, iridocyclitis, chorioretinitis, and proptosis. Lid edema, orbital inflammation, muscle palsies, and corneal melting may also occur. Case report An 83-year-old man previously diagnosed with RPC presented to our clinic with acute unilateral chemosis, conjunctivitis, lid edema, proptosis, and extraocular muscle restriction. After orbital cellulitis was ruled out, further evaluation revealed posterior scleritis with choroidal detachment OS. A course of oral indomethacin and topical antibiotic-steroid combination drops was implemented in the treatment of the ocular manifestations. The quick positive response to the anti-inflammatory agents confirmed the diagnosis of ocular complications secondary to RPC. Discussion: The presenting ocular signs and symptoms of RPC often resemble other commonly encountered ocular conditions. It is important for the eye care practitioner to be familiar with the ocular manifestations of RPC because the eyes are sometimes the initial site of involvement and may be a marker of severity. Early diagnosis and intervention may significantly improve the patient's outcome. This case report with literature review will hopefully bring to light features of this disease which will help the eye care practitioner in the diagnosis and management of this condition. C1 Sepulveda Ambulatory Care Ctr, VA Greater Los Angeles Healthcare Syst, Fullerton, CA USA. RP Chow, MT (reprint author), 128 Shawnee Ave, San Francisco, CA 94112 USA. NR 46 TC 7 Z9 10 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-5488 J9 OPTOMETRY VISION SCI JI Optom. Vis. Sci. PD JUN PY 2000 VL 77 IS 6 BP 286 EP 292 DI 10.1097/00006324-200006000-00008 PG 7 WC Ophthalmology SC Ophthalmology GA 328XR UT WOS:000087877500011 PM 10879785 ER PT J AU Sing, NMT Anderson, SF Townsend, JC AF Sing, NMT Anderson, SF Townsend, JC TI The normal optic nerve head SO OPTOMETRY AND VISION SCIENCE LA English DT Article DE optic nerve head; optic disc; optic cup; cup/disc ratio; neuroretinal rim; retinal nerve fiber layer; relative hypoplasia; hypoplasia; computerized image analysis ID NEURORETINAL RIM AREA; HUMAN LAMINA-CRIBROSA; OPEN-ANGLE GLAUCOMA; AGE-RELATED DECLINE; NORMAL HUMAN EYES; FIBER LAYER; DISK SIZE; DIAMETER DISTRIBUTION; REFRACTIVE ERROR; AXON DIAMETER AB Background: The normal optic nerve head varies from one person to another, and there is often intraindividual variation as well. Factors such as race and age play an important role in distinguishing what may be considered normal variations in optic nerve head appearance. Methods: A literature search and review of the latest studies on the optic nerve head was conducted. Results: Results of recent studies showed that variations in the average cup-to-disc ratio exist for different races, and with age there is a gradual loss of nerve fibers leading to an overall increase in the cup-to-disc ratio. There is also evidence that congenitally larger optic nerves have larger cup-to-disc ratios and more nerve fibers. Smaller optic nerves, in contrast, have smaller cup-to-disc ratios and fewer nerve fibers. These findings are presented along with sample photographs depicting the normal variations in optic nerve head appearance. Conclusion: Over the past 30 years, technology has allowed for changing Views about what may be considered normal in reference to the optic nerve head, This information is valuable to the eye care practitioner in helping to make appropriate patient care management decisions. C1 Sepulveda Ambulatory Care Ctr & Nursing Home, VA Greater Los Angeles Healthcare Syst, Sepulveda, CA USA. RP Sing, NMT (reprint author), 6601 Tennyson St NE 10204, Albuquerque, NM 87111 USA. NR 80 TC 8 Z9 8 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-5488 J9 OPTOMETRY VISION SCI JI Optom. Vis. Sci. PD JUN PY 2000 VL 77 IS 6 BP 293 EP 301 PG 9 WC Ophthalmology SC Ophthalmology GA 328XR UT WOS:000087877500012 PM 10879786 ER PT J AU Matzke, GR Frye, RF Joy, MS Palevsky, PM AF Matzke, GR Frye, RF Joy, MS Palevsky, PM TI Determinants of ceftriaxone clearance by continuous venovenous hemofiltration and hemodialysis SO PHARMACOTHERAPY LA English DT Article ID RENAL REPLACEMENT THERAPIES; POLYSULFONE MEMBRANES; PHARMACOKINETICS; FAILURE AB Study Objective. To guide individual ceftriaxone dosages in patients receiving continuous renal replacement therapy Design. Prospective, outpatient study. Setting. University-affiliated general clinical research center. Patients. Eight patients receiving hemodialysis. Intervention. We performed controlled clearance studies with three hemofilters: an acrylonitrile copolymer 0.6 m(2) (AN69), polymethylmethacrylate 2.1 m(2) (PMMA), and polysulfone 0.65 m(2) (PS). Measurements and Main Results. Subjects received ceftriaxone 1000 mg intravenously before the start of a clearance study. The concentration of ceftriaxone in multiple plasma and dialysate-ultrafiltrate samples was determined by high-performance liquid chromatography. The diffusional clearances (Cl-diffusion) and sieving coefficients (SC) of ceftriaxone, urea, and creatinine were compared by a mixed-model repeated-measures analysis of variance with filter and blood, dialysate inflow or ultrafiltration rate as the main effect and patient as a random effect. The fraction of ceftriaxone bound to plasma proteins was 43 +/- 15% (range 13-92%). Concentration dependence was evident in all three groups. The fraction unbound to plasma proteins (f(up)) at the time that SCs were determined was significantly lower in the PS group (0.16 +/- 0.07) than the AN69 group (0.30 +/- 0.17, p<0.01), but similar to that in the PMMA group (0.27 +/- 0.12). Despite the higher f(up), the SC of unbound ceftriaxone with the AN69 filter (0.48 +/- 0.13) was significantly lower than values for the PMMA (0.86 +/- 0.33) and PS (0.82 +/- 0.22) groups (p<0.05). Continuous venovenous hemofiltration clearance of urea and unbound ceftriaxone increased significantly only for the PMMA (p=0.006) and PS (p=0.015) filters when the ultrafiltration rate was increased. Significant linear relationships (p<0.0001) were observed between Cl-diffusion of unbound ceftriaxone and clearance of urea for all three filters: AN69 slope = 0.57, PMMA slope = 0.90, and PS slope = 1.02. The slope of this relationship for the AN69 filter was significantly lower than for the other two filters. Conclusion. Ceftriaxone clearance was significantly increased and membrane dependent during continuous venovenous hemofiltration and continuous venovenous hemodialysis. Thus individual ceftriaxone dosages for patients receiving continuous renal replacement therapies should incorporate extracorporeal clearance. C1 Univ Pittsburgh, Sch Pharm, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Ctr Clin Pharmacol, Pittsburgh, PA 15261 USA. VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. Univ N Carolina, Sch Med, Div Nephrol & Hypertens, Chapel Hill, NC USA. RP Matzke, GR (reprint author), Univ Pittsburgh, Sch Pharm, 724 Salk Hall, Pittsburgh, PA 15261 USA. OI Palevsky, Paul/0000-0002-7334-5400; Frye, Reginald/0000-0002-1841-1401 FU NCRR NIH HHS [5M01 RR00056] NR 30 TC 23 Z9 24 U1 0 U2 1 PU PHARMACOTHERAPY PUBLICATIONS INC PI BOSTON PA NEW ENGLAND MEDICAL CENTER BOX 806 171 HARRISON AVE, BOSTON, MA 02111 USA SN 0277-0008 J9 PHARMACOTHERAPY JI Pharmacotherapy PD JUN PY 2000 VL 20 IS 6 BP 635 EP 643 DI 10.1592/phco.20.7.635.35170 PG 9 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 320ZX UT WOS:000087431400004 PM 10853618 ER PT J AU Thompson, SC Woods, SC Hendricks, S Bell, SM Figlewicz, DP AF Thompson, SC Woods, SC Hendricks, S Bell, SM Figlewicz, DP TI Intraventricular insulin suppresses the acoustic startle response in rats SO PHYSIOLOGY & BEHAVIOR LA English DT Article DE insulin; acoustic startle response; reuptake blocker; norepinephrine ID LOCUS-COERULEUS; IN-VIVO; NOREPINEPHRINE; MODULATION; INHIBITION; DOPAMINE; NEURONS; BRAIN; ALPHA(2)-ADRENOCEPTORS; AMPHETAMINE AB We and others have previously reported that the hormone insulin alters brain noradrenergic function at the synaptic and molecular levels. In the: present study, we examined the in vivo effect of insulin (administered chronically via osmotic minipumps at a dose of 5 mU/day into the third cerebral ventricle) on thr acoustic startle response. Rats receiving chronic intraventricular insulin had a significantly reduced startle response relative to vehicle-treated controls (i.e., 47 +/- 21% of baseline control startle response). Because our previous findings suggest that on an acute basis, insulin may enhance endogenous noradrenergic activity by inhibiting norepinephrine reuptake, we speculate here that the chronic effect of insulin is similar to that of the noradrenergic reuptake blocker, desipramine, which has been reported to decrease baseline startle performance. (C) 2000 Elsevier Science Inc. All rights reserved. C1 VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Nebraska, Dept Psychol, Omaha, NE 68182 USA. Univ Nebraska, Dept Pharmacol, Omaha, NE 68182 USA. Univ Cincinnati, Dept Psychiat, Cincinnati, OH 45267 USA. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. RP Figlewicz, DP (reprint author), VA Puget Sound Hlth Care Syst, 151,1660 So Columbian Way, Seattle, WA 98108 USA. FU NIDDK NIH HHS [DK17844, DK40963] NR 29 TC 3 Z9 3 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0031-9384 J9 PHYSIOL BEHAV JI Physiol. Behav. PD JUN 1 PY 2000 VL 69 IS 4-5 BP 433 EP 437 DI 10.1016/S0031-9384(99)00260-7 PG 5 WC Psychology, Biological; Behavioral Sciences SC Psychology; Behavioral Sciences GA 336AY UT WOS:000088280800007 PM 10913781 ER PT J AU Netscher, DT Meade, RA Goodman, CM Brehm, BJ Friedman, JD Thornby, J AF Netscher, DT Meade, RA Goodman, CM Brehm, BJ Friedman, JD Thornby, J TI Physical and psychosocial symptoms among 88 volunteer subjects compared with patients seeking plastic surgery procedures to the breast SO PLASTIC AND RECONSTRUCTIVE SURGERY LA English DT Article ID REDUCTION MAMMAPLASTY AB In an investigation of the relationship between macro-mastia and physical and psychosocial symptoms, 88 female university students, 21 augmentation mammaplasty patients, and 31 breast reduction patients graded somatic and psychosocial symptoms. The intent of the study was to discover which complaints were most common among women presenting for reduction mammaplasty and to determine whether height/weight index and brassiere chest measurement and cup size might affect their symptoms. Both the student group and the augmentation mammaplasty patients differed significantly from the breast I-eduction patients. Eighty-one percent of the reduction patients complained of neck and back pain. Seventy-seven percent complained of shoulder pain, 58 percent complained of chafing or rash; 45 percent reported significant limitation in their activity; and 52 percent were unhappy with their appearance (p < 0.001 compared with augmentation and student groups). Physical symptoms were I-elated to height/weight index and bra chest and cup sizes in each of the three participating groups. It was found that patients who present for symptom-related reduction mammaplasty have a disease-specific group of physical and psychosocial complaints that are more directly related to large breast size than to being overweight. C1 Baylor Coll Med, Div Plast Surg, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Houston, TX USA. RP Netscher, DT (reprint author), 6560 Fannin,Suite 800, Houston, TX 77030 USA. NR 9 TC 20 Z9 23 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0032-1052 J9 PLAST RECONSTR SURG JI Plast. Reconstr. Surg. PD JUN PY 2000 VL 105 IS 7 BP 2366 EP 2373 DI 10.1097/00006534-200006000-00009 PG 8 WC Surgery SC Surgery GA 318HF UT WOS:000087277300009 PM 10845288 ER PT J AU Huber, MG Balon, R Labbate, LA Brandt-Youtz, S Hammer, JH Mufti, R AF Huber, MG Balon, R Labbate, LA Brandt-Youtz, S Hammer, JH Mufti, R TI A survey of police officers' experience with Tarasoff warnings in two states SO PSYCHIATRIC SERVICES LA English DT Article ID PROTECT; DUTY AB A desk sergeant at each of 48 Michigan police stations and 52 South Carolina police stations was surveyed about: knowledge and experience of Tarasoff warnings. Respondents at 45 stations reported receiving warnings from mental health professionals, with a mean+/-SD of 3.7+/-8.4 warnings a year. Only three respondents were familiar with the Tarasoff ruling. Twenty-four stations had a specific policy on such warnings. Twenty-seven stations would not warn a potential victim. Michigan stations were much more likely than South Carolina stations to have experience with or policies on Tarasoff warnings. Because police apparently have limited experience with Tarasoff warnings, calling them may not be the best way to protect potential victims from patients making threats. C1 Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Wayne State Univ, Sch Med, Dept Psychiat & Behav Neurosci, Detroit, MI USA. Med Univ S Carolina, Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29425 USA. RP Huber, MG (reprint author), VA Med Ctr, 109 Bee St, Charleston, SC 29401 USA. NR 8 TC 7 Z9 7 U1 0 U2 0 PU AMER PSYCHIATRIC PRESS, INC PI WASHINGTON PA 1400 K ST, N W, STE 1101, WASHINGTON, DC 20005 USA SN 1075-2730 J9 PSYCHIATR SERV JI Psychiatr. Serv. PD JUN PY 2000 VL 51 IS 6 BP 807 EP 809 DI 10.1176/appi.ps.51.6.807 PG 3 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 321WN UT WOS:000087477800017 PM 10828115 ER PT J AU Douek, DC Vescio, RA Betts, MR Brenchley, JM Hill, BJ Zhang, L Berenson, JR Collins, RH Koup, RA AF Douek, DC Vescio, RA Betts, MR Brenchley, JM Hill, BJ Zhang, L Berenson, JR Collins, RH Koup, RA TI Assessment of thymic output in adults after haematopoietic stem-cell transplantation and prediction of T-cell reconstitution SO LANCET LA English DT Article ID BONE-MARROW TRANSPLANTATION; INTENSIVE CHEMOTHERAPY; IMMUNE RECONSTITUTION; AGE; EXPANSION; MEMORY; THYMOPOIESIS; REGENERATION; PROGENITORS; GENERATION AB Background The potential benefits of haematopoietic stem-cell transplantation are tempered by the depletion of T-cells accompanying this procedure. We used a new technique which quantifies the excisional DNA products of T-cell-receptor (TCR) gene rearrangement to measure thymic output directly in patients with multiple myeloma, and thus assessed the contribution of the thymus to immune recovery after transplantation. Methods We studied 40 patients, 34-66 years of age, who had been randomly assigned myeloablative chemotherapy and autologous peripheral-blood haematopoietic stem-cell transplantation with unmanipulated grafts or grafts enriched for CD34 stem cells. CD4 and CD8 T-cell counts were measured, thymic output was estimated serially until 2 years after transplantation, and percentages of naive T-cells were measured. Findings The production of substantial numbers of new naive T cells by the thymus could be detected by 100 days post-transplant; there was a significant inverse relation between age and recovery of new T cells. In the CD34-unselected group, numbers of TCR-rearrangement excision circles returned to baseline after 2 years, whereas in the CD34-selected group, numbers at 2 years were significantly higher than both baseline numbers (p=0.004), and 2-year numbers in the unselected group (p=0.046). Increased thymic output correlated with, and was predictive of, increased naive T-cell numbers and broader T-cell-receptor repertoires. Interpretation Our results provide evidence that the adult thymus contributes more substantially to immune reconstitution after haematopoietic stem-cell transplantation than was previously thought, and therefore could be a target for therapeutic intervention. C1 Univ Texas, SW Med Ctr, Dept Internal Med, Dallas, TX 75390 USA. Univ Calif Los Angeles, W Los Angeles Vet Affairs Med Ctr, Dept Hematol Oncol, Los Angeles, CA USA. RP Douek, DC (reprint author), Univ Texas, SW Med Ctr, Dept Internal Med, Dallas, TX 75390 USA. FU NIAID NIH HHS [AI44758] NR 31 TC 360 Z9 372 U1 0 U2 5 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD MAY 27 PY 2000 VL 355 IS 9218 BP 1875 EP 1881 DI 10.1016/S0140-6736(00)02293-5 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 318VZ UT WOS:000087306500015 PM 10866444 ER PT J AU Canto, JG Every, NR Magid, DJ Rogers, WJ Malmgren, JA Frederick, PD French, WJ Tiefenbrunn, AJ Misra, VK Kiefe, CI Barron, HV AF Canto, JG Every, NR Magid, DJ Rogers, WJ Malmgren, JA Frederick, PD French, WJ Tiefenbrunn, AJ Misra, VK Kiefe, CI Barron, HV CA Natl Registry Myocardial Infarctio TI The volume of primary angioplasty procedures and survival after acute myocardial infarction SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID NATIONAL REGISTRY; ASSOCIATION; HOSPITALS; CARDIOLOGY; MORTALITY; OUTCOMES; PROJECT; CARE AB Background: There is an inverse relation between mortality from cardiovascular causes and the number of elective cardiac procedures (coronary angioplasty, stenting, or coronary bypass surgery) performed by individual practitioners or hospitals. However, it is not known whether patients with acute myocardial infarction fare better at centers where more patients undergo primary angioplasty or thrombolytic therapy than at centers with lower volumes. Methods: We analyzed data from the National Registry of Myocardial Infarction to determine the relation between the number of patients receiving reperfusion therapy (primary angioplasty or thrombolytic therapy) and subsequent in-hospital mortality. A total of 450 hospitals were divided into quartiles according to the volume of primary angioplasty. Multiple logistic-regression models were used to determine whether the volume of primary angioplasty procedures was an independent predictor of in-hospital mortality among patients undergoing this procedure. Similar analyses were performed for patients receiving thrombolytic therapy at 516 hospitals. Results: In-hospital mortality was 28 percent lower among patients who underwent primary angioplasty at hospitals with the highest volume than among those who underwent angioplasty at hospitals with the lowest volume (adjusted relative risk, 0.72; 95 percent confidence interval, 0.60 to 0.87; P<0.001). This lower rate, which represented 2.0 fewer deaths per 100 patients treated, was independent of the total volume of patients with myocardial infarction at each hospital, year of admission, and use or nonuse of adjunctive pharmacologic therapies. There was no significant relation between the volume of thrombolytic interventions and in-hospital mortality among patients who received thrombolytic therapy (7.0 percent for patients in the highest-volume hospitals vs. 6.9 percent for those in the lowest-volume hospitals, P=0.36). Conclusions: Among hospitals in the United States that have full interventional capabilities, a higher volume of angioplasty procedures is associated with a lower mortality rate among patients undergoing primary angioplasty, but there is no association between volume and mortality for thrombolytic therapy. (N Engl J Med 2000;342:1573-80.) (C) 2000, Massachusetts Medical Society. C1 Univ Alabama, Dept Med, Div Cardiovasc Dis, Birmingham, AL 35294 USA. Univ Alabama, Ctr Outcomes & Effectiveness Res & Educ, Birmingham, AL 35294 USA. Univ Washington, Cardiovasc Outcomes Res Ctr, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. Colorado Permanente Med Grp, Clin Res Unit, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Div Emergency Med, Denver, CO USA. Harbor UCLA Med Ctr, Torrance, CA 90509 USA. Washington Univ, Sch Med, St Louis, MO USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Genentech Inc, S San Francisco, CA 94080 USA. RP Canto, JG (reprint author), Univ Alabama, Dept Med, Div Cardiovasc Dis, 363 BDB,1808 7th Ave S, Birmingham, AL 35294 USA. FU AHRQ HHS [HS08843] NR 15 TC 229 Z9 242 U1 1 U2 5 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAY 25 PY 2000 VL 342 IS 21 BP 1573 EP 1580 DI 10.1056/NEJM200005253422106 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 316XJ UT WOS:000087193100006 PM 10824077 ER PT J AU Adrogue, HJ Madias, NE AF Adrogue, HJ Madias, NE TI Primary care: Hyponatremia. SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Review ID CENTRAL PONTINE MYELINOLYSIS; SEVERE SYMPTOMATIC HYPONATREMIA; ANTI-DIURETIC HORMONE; RAPID CORRECTION; INAPPROPRIATE SECRETION; MAGNETIC-RESONANCE; NEUROLOGIC COMPLICATIONS; ORGANIC OSMOLYTES; MANAGEMENT; VASOPRESSIN C1 New England Med Ctr, Div Nephrol, Boston, MA 02111 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Renal Sect, Houston, TX USA. Tufts Univ, Sch Med, Dept Med, Boston, MA 02111 USA. New England Med Ctr, Tupper Res Inst, Boston, MA 02111 USA. RP Madias, NE (reprint author), New England Med Ctr, Div Nephrol, Box 172,750 Washington St, Boston, MA 02111 USA. NR 60 TC 680 Z9 719 U1 2 U2 33 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAY 25 PY 2000 VL 342 IS 21 BP 1581 EP 1589 DI 10.1056/NEJM200005253422107 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 316XJ UT WOS:000087193100007 PM 10824078 ER PT J AU Murray, DR Prabhu, SD Chandrasekar, B AF Murray, DR Prabhu, SD Chandrasekar, B TI Chronic beta-adrenergic stimulation induces myocardial proinflammatory cytokine expression SO CIRCULATION LA English DT Article DE isoproterenol; tumor necrosis factor-alpha; interleukins; sympathetic nervous system; myocardium ID TUMOR-NECROSIS-FACTOR; CARDIAC MYOCYTES; DISEASE; HEART AB Background-The sympathetic nervous system and proinflammatory cytokines are believed to play key roles in the pathophysiology of congestive heart failure. To evaluate a possible relationship between these neurohormonal systems, we studied the effects of chronic beta-adrenergic stimulation on the myocardial and systemic elaboration of tumor necrosis factor (TNF)-alpha, interleukin (LL)-1 beta, and IL-6. Methods and Results-Male rats received either L-isoproterenol (2.4 mg . kg(-1) . d(-1), n=8) or saline (n=7) via miniosmotic pumps for 7 days. Myocardial cytokine expression was analyzed by both Northern and Western blotting and localized in the tissue using immunohistochemistry. ELISA was performed to measure circulating levels of cytokines. In myocardium from control animals, neither TNF-alpha nor IL-1 beta were detected, whereas IL-6 was present at very low levels. Isoproterenol led to a significant (P<0.01) increase in mRNA and protein expression of all 3 cytokines. Immunohistochemistry did not detect immunoreactivity for either cytokine in myocardium from controls; however, all 3 cytokines were readily detected (P<0.05) throughout the myocardium, localized to resident cells and vessels, in animals treated with isoproterenol, Neither treatment group had detectable levels of cytokines in the serum. Conclusions-Chronic beta-adrenergic stimulation induces myocardial, but not systemic, elaboration of TNF-alpha, IL-1 beta, and IL-6. C1 Univ Texas, Hlth Sci Ctr, Dept Med Cardiol, San Antonio, TX 78229 USA. S Texas Vet Healthcare Syst, Audie Murphy Div, San Antonio, TX USA. Univ Louisville, Louisville VA Med Ctr, Louisville, KY 40292 USA. RP Murray, DR (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med Cardiol, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. RI Prabhu, Sumanth/D-5223-2009 NR 13 TC 151 Z9 169 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD MAY 23 PY 2000 VL 101 IS 20 BP 2338 EP 2341 PG 4 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 316EY UT WOS:000087155700003 PM 10821806 ER PT J AU Preston, RA Materson, BJ Reda, DJ Williams, DW AF Preston, RA Materson, BJ Reda, DJ Williams, DW TI Placebo-associated blood pressure response and adverse effects in the treatment of hypertension - Observations from a Department of Veterans Affairs Cooperative Study SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID 6 ANTIHYPERTENSIVE AGENTS; SINGLE-DRUG THERAPY; CLINICAL-TRIALS; DEVELOPING-COUNTRIES; TRANSMISSION; BENEFITS; ETHICS; MANIA AB Background: The use of placebo in clinical trials has been vigorously debated. Placebo control may be useful in disease states, such as stage 1 and stage 2 hypertension as defined by the Sixth Report of the Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC VI), in which response rates for placebo are high or close to response rates for effective therapies, or when established interventions have significant adverse effects. Objective: To compare rates for the control of blood pressure and adverse effects of placebo vs active treatment in patients with stage 1 and stage 2 hypertension. Methods: This study is a randomized controlled trial evaluating the blood pressure response and adverse effects of placebo vs 6 active treatments administered in 15 Veterans Affairs hypertension centers. The 1292 subjects of the Veterans Affairs Cooperative Study receiving single-drug therapy for hypertension were randomly allocated to receive treatment with 1 of 6 active drugs (n=1105) or placebo (n=187). Treatment success was defined as maintaining a diastolic blood pressure of less than 95 mm Hg for at least 1 year. We compared treatment success rates for the control of blood pressure and adverse effects of placebo vs active treatment. Using the Kaplan-Meier method, we also compared rates of discontinuation from placebo vs active drug treatment over time as a result of adverse drug effects and blood pressure exceeding safety limits. Results: At the end of the titration phase, 58 patients who were treated with placebo (31%) achieved a goal diastolic blood pressure lower than 90 mm Hg and 57 (30%) achieved success at 1 year. Older white patients who received placebo had a success rate of 38% vs 23% to 27% for the other age-race subgroups. The rates of discontinuation as a result of adverse drug effects were 13% for patients receiving placebo vs 12% for patients receiving active treatment (P=.40). The rates of discontinuation for blood pressure being too high were 14% for patients receiving placebo vs 7% for patients receiving active treatment(P=.01). Conclusions: Placebo control provides an important benchmark for both efficacy and adverse effects. It continues to have an appropriate place in certain therapeutic trials, particularly those involving the treatment of stage 1 and stage 2 hypertension. C1 Univ Miami, Sch Med, Div Clin Pharmacol, Miami, FL USA. Univ Miami, Sch Med, Dept Med, Miami, FL USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Cooperat Studies Program, Hines, IL 60141 USA. RP Preston, RA (reprint author), Univ Miami, Sch Med, Div Clin Pharmacol & Pharmacokinet, 1500 NW 12th Ave,15th Floor,W Tower, Miami, FL 33136 USA. NR 40 TC 54 Z9 54 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD MAY 22 PY 2000 VL 160 IS 10 BP 1449 EP 1454 DI 10.1001/archinte.160.10.1449 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 315PJ UT WOS:000087121900007 PM 10826457 ER PT J AU Adrogue, HJ Madias, NE AF Adrogue, HJ Madias, NE TI Primary care - Hypernatremia SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Review ID SYSTEM; VOLUME C1 New England Med Ctr, Div Nephrol, Boston, MA 02111 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Methodist Hosp, Houston, TX 77030 USA. Dept Vet Affairs Med Ctr, Renal Sect, Houston, TX USA. Tufts Univ, Sch Med, Dept Med, Boston, MA 02111 USA. New England Med Ctr, Tupper Res Inst, Boston, MA 02111 USA. RP Madias, NE (reprint author), New England Med Ctr, Div Nephrol, Box 172,750 Washington St, Boston, MA 02111 USA. NR 28 TC 307 Z9 340 U1 1 U2 21 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAY 18 PY 2000 VL 342 IS 20 BP 1493 EP 1499 DI 10.1056/NEJM200005183422006 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 314QT UT WOS:000087068200006 PM 10816188 ER PT J AU Chen, L Chen, MH Larson, MG Evans, J Benjamin, EJ Levy, D AF Chen, L Chen, MH Larson, MG Evans, J Benjamin, EJ Levy, D TI Risk factors for syncope in a community-based sample (The Framingham Heart Study) SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID HYPERTROPHIC CARDIOMYOPATHY; DIAGNOSING SYNCOPE; SUDDEN-DEATH; MANAGEMENT; FAILURE AB The epidemiology of syncope has not been well described. Prior studies have examined risk factors for syncope in hospital-based or other acute or long-term core settings. To determine risk factors for syncope in a community-based sample, we performed a nested case-control study. We examined reports of syncope in Framingham Heart Study participants who underwent routine clinic visits from 1971 to 1990. For each syncope case (n = 543) 2 controls were matched for age, sex, and examination period. Mean age of subjects was 67 years (range 25 to 95); 59% were women. History of stroke or transient ischemic attack, history of myocardial infarction, high blood pressure, use of antihypertensive medication, use of other cardiac medication, smoking, alcohol intake, body moss index, systolic blood pressure, diastolic blood pressure, heart rate, atrial fibrillation, PR interval prolongation, interventricular block, and diabetes or elevated glucose level were examined as potential predictors. Using conditional logistic regression analysis, the predictors of syncope included a history of stroke or transient ischemic attack (odds ratio [OR] 2.56, 95% confidence interval [CI] 1.62 to 4.04), use of cardiac medication (OR 1.67, 95% CI 1.21 to 2.30), and high blood pressure (OR 1.46, 95% CI 1.14 to 1.88). Lower body mass index was marginally associated with syncope (OR per 4 kg/m(2) decrement 1.10, 95% CI 0.99 to 1.22), as were increased alcohol intake (OR per 5 oz/week 1.11, 95% CI 0.99 to 1.26), and diabetes or on elevated glucose level (OR 1.29, 95% CI 0.96 to 1.75). To our knowledge, this study represents the first community-based study of risk factors for syncope. (C) 2000 by Excerpta Medica, Inc. C1 NHLBI, Framingham Heart Study, Framingham, MA 01702 USA. NHLBI, Bethesda, MD 20892 USA. Boston Med Ctr, Div Cardiol & Prevent Med, Boston, MA USA. Beth Israel Deaconess Med Ctr, Div Cardiol, Boston, MA USA. Beth Israel Deaconess Med Ctr, Div Clin Epidemiol, Boston, MA USA. VA Puget Sound Hlth Care Syst, NW Hlth Serv Res & Dev Field Program, Seattle, WA USA. RP Levy, D (reprint author), NHLBI, Framingham Heart Study, 5 Thurber St, Framingham, MA 01702 USA. OI Benjamin, Emelia/0000-0003-4076-2336 FU NHLBI NIH HHS [N01-HC-38038]; NINDS NIH HHS [5-R01-NS-17950-16] NR 28 TC 17 Z9 22 U1 0 U2 1 PU EXCERPTA MEDICA INC PI NEW YORK PA 245 WEST 17TH STREET, NEW YORK, NY 10011 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD MAY 15 PY 2000 VL 85 IS 10 BP 1189 EP 1193 DI 10.1016/S0002-9149(00)00726-8 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 312LV UT WOS:000086945500006 PM 10801999 ER PT J AU Tatsuta, T Shiraishi, A Mountz, JD AF Tatsuta, T Shiraishi, A Mountz, JD TI The prodomain of caspase-1 enhances Fas-mediated apoptosis through facilitation of caspase-8 activation SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID TUMOR-NECROSIS-FACTOR; INTERLEUKIN-1-BETA CONVERTING-ENZYME; DOMAIN-CONTAINING RECEPTOR; ICE FAMILY PROTEASES; CELL-DEATH; MONOCLONAL-ANTIBODY; CONTAINING PROTEIN; MAMMALIAN HOMOLOG; MOLECULAR-CLONING; ADAPTER MOLECULE AB Caspase-1 (interleukin-1 beta converting enzyme) is produced in the form of a latent precursor, which is cleaved to yield a prodomain in addition to the p20 and p10 subunits. It has been established that the (p20/p10)(2) heterotetramer processes the latent precursor of interleukin-1 beta into an active form during apoptosis, but the function of the residual prodomain of caspase-1 (Pro-C1) has not been established. To evaluate the involvement of Pro-C1 in apoptosis, a Pro-C1 expression vector was transfected into the HeLa cell line, which is susceptible to Fas-mediated apoptosis. Expression of recombinant Pro-C1 in HeLa cells enhanced apoptosis mediated by Fas, but not etoposide-induced apoptosis. This enhancement of Fas-mediated apoptosis was abolished by inhibitors of caspase-8 (Ile-Glu-Thr-Asp-fluoromethyl ketone) and caspase-3 (Asp-Glu-Val-Asp-aldehyde) but was only slightly diminished by an inhibitor of caspase-1 (acetyl- Tyr-Val-Ala-Asp-chloromethyl ketone). During apoptosis induced by an agonistic anti-Fas antibody, the activation of caspase-8 and caspase-3 was more pronounced and occurred more rapidly in HeLa/Pro-C1 cells than in the empty vector transfectant (HeLa/vec) cells; in contrast, caspase-1 was not activated in either HeLa/Pro-C1 or HeLa/vec cells. These results demonstrate an additional and novel function for caspase-1 in which Pro-C1 acts to enhance Fas-mediated apoptosis, most probably through facilitation of the activation of caspase-8. C1 Sankyo Co Ltd, Neurosci & Immunol Res Labs, Tokyo 1408710, Japan. Univ Alabama, Birmingham, AL 35294 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL 35294 USA. RP Tatsuta, T (reprint author), Sankyo Co Ltd, Neurosci & Immunol Res Labs, 1-2-58 Hiromachi, Tokyo 1408710, Japan. NR 45 TC 40 Z9 40 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD MAY 12 PY 2000 VL 275 IS 19 BP 14248 EP 14254 DI 10.1074/jbc.275.19.14248 PG 7 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 313NZ UT WOS:000087006900034 PM 10799503 ER PT J AU Hirsch, MS Brun-Vezinet, F D'Aquila, RT Hammer, SM Johnson, VA Kuritzkes, DR Loveday, C Mellors, JW Clotet, B Conway, B Demeter, LM Vella, S Jacobsen, DM Richman, DD AF Hirsch, MS Brun-Vezinet, F D'Aquila, RT Hammer, SM Johnson, VA Kuritzkes, DR Loveday, C Mellors, JW Clotet, B Conway, B Demeter, LM Vella, S Jacobsen, DM Richman, DD TI Antiretroviral drug resistance testing in adult HIV-1 infection - Recommendations of an International AIDS Society-USA panel SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID IMMUNODEFICIENCY-VIRUS TYPE-1; REVERSE-TRANSCRIPTASE GENE; PROTEASE INHIBITORS; COMBINATION THERAPY; ZIDOVUDINE RESISTANCE; GENOTYPIC RESISTANCE; CONTROLLED TRIAL; DUAL RESISTANCE; VIRAL LOAD; IN-VIVO AB Objective Assays for drug resistance testing in human immunodeficiency virus type 1 (HIV-1) infection are now available and clinical studies suggest that viral drug resistance is correlated with poor virologic response to new therapy. The International AIDS Society-USA sought to update prior recommendations to provide guidance for clinicians regarding indications for HIV-1 resistance testing. Participants An International AIDS Society-USA 13-member physician panel with expertise in basic science, clinical research, and patient care involving HIV resistance to antiretroviral drugs was reconvened to provide recommendations for the clinical use of drug resistance testing. Evidence and Consensus Process The full panel met regularly between January and October 1999. Resistance and resistance testing data appearing in the last decade th rough April 2000 and presentations at national and international research conferences were reviewed. Recommendations and considerations were developed by 100% group consensus, acknowledging that definitive data to support final recommendations are not yet available. Conclusions Emerging data indicate that despite limitations, resistance testing should be incorporated into patient management in some settings. Resistance testing is recommended to help guide the choice of new regimens after treatment failure and for guiding therapy for pregnant women. It should be considered in treatment-naive patients with established infection, but cannot be firmly recommended in this setting. Testing also should be considered prior to initiating therapy in patients with acute HIV infection, although therapy should not be delayed pending the results. Expert interpretation is recommended given the complexity of results and assay limitations. C1 Harvard Univ, Sch Med, Boston, MA USA. Hop Bichat Claude Bernard, F-75877 Paris 18, France. Columbia Univ, Coll Phys & Surg, New York, NY USA. Univ Alabama, Sch Med, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Royal Free Hosp, Sch Med, London, England. Vet Affairs Med Ctr, Pittsburgh, PA USA. Univ Pittsburgh, Pittsburgh, PA USA. Fdn IrsaCAIXA, Barcelona, Spain. Hosp Univ Germans Trias & Pujol, HIV Unit, Barcelona, Spain. Univ British Columbia, Vancouver, BC V5Z 1M9, Canada. Univ Rochester, Rochester, NY USA. Ist Super Sanita, I-00161 Rome, Italy. Univ Calif San Diego, San Diego, CA 92103 USA. San Diego Vet Affairs Med Ctr, San Diego, CA USA. Infect Dis Unit, Boston, MA 02114 USA. RP Hirsch, MS (reprint author), Int AIDS Soc USA, Presidio San Francisco,1001 B OReilly Ave,Box 29, San Francisco, CA 94129 USA. RI Vella, Stefano/D-4912-2015 OI Vella, Stefano/0000-0003-2347-5984 NR 94 TC 548 Z9 555 U1 0 U2 8 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 10 PY 2000 VL 283 IS 18 BP 2417 EP 2426 DI 10.1001/jama.283.18.2417 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 310CD UT WOS:000086808200037 PM 10815085 ER PT J AU Chandrasekar, B Mitchell, DH Colston, JT Freeman, GL AF Chandrasekar, B Mitchell, DH Colston, JT Freeman, GL TI Is leptin involved in the signaling cascade after myocardial ischemia and reperfusion? Response SO CIRCULATION LA English DT Letter ID EXPRESSION; ENDOTOXIN; RECEPTOR C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Hosp, San Antonio, TX 78284 USA. RP Chandrasekar, B (reprint author), Univ Texas, Hlth Sci Ctr, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. NR 5 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD MAY 9 PY 2000 VL 101 IS 18 BP E194 EP E194 PG 1 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 311TV UT WOS:000086902500009 ER PT J AU Conigliaro, J Whittle, J Good, CB Hanusa, BH Passman, LJ Lofgren, RP Allman, R Ubel, PA O'Connor, M Macpherson, DS AF Conigliaro, J Whittle, J Good, CB Hanusa, BH Passman, LJ Lofgren, RP Allman, R Ubel, PA O'Connor, M Macpherson, DS TI Understanding racial variation in the use of coronary revascularization procedures - The role of clinical factors SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID BYPASS GRAFT-SURGERY; OF-VETERANS-AFFAIRS; BLACK-AND-WHITE; ARTERY DISEASE; HEART-DISEASE; MYOCARDIAL-INFARCTION; MORTALITY; REGISTRY; SURVIVAL; ANGIOGRAPHY AB Background: Black patients undergo coronary artery bypass grafting and percutaneous transluminal coronary angioplasty less often than white patients. It is unclear how racial differences in clinical factors contribute to this variation. Methods: A retrospective cohort study was performed of 666 male patients (326 blacks and 340 whites), admitted to 1 of 6 Veterans Affairs hospitals from October 1, 1989, to September 30, 1995, with acute myocardial infarction or unstable angina who underwent cardiac catheterization. The primary comparison was whether racial differences in percutaneous transluminal coronary angioplasty and coronary artery bypass grafting rates persisted after stratifying by clinical appropriateness of the procedure, measured by the appropriateness scale developed by the RAND Corporation, Santa Monica, Calif. Results: Whites more often than blacks underwent a revascularization procedure (47% vs 28%). There was substantial variation in black-white odds ratios within differ ent appropriateness categories. Blacks were significantly less likely to undergo percutaneous transluminal coronary angioplasty (odds ratio, 0.30; 95% confidence interval, 0.14-0.63 [P<.01]) when the indication was rated "equivocal." Similarly, blacks were less likely to undergo coronary artery bypass grafting (odds ratio, 0.44; 95% confidence interval, 0.23-0.86 [P<.01]) when only coronary artery bypass grafting was indicated as "appropriate and necessary." Differences in comorbidity or use of cigarettes or alcohol did nor explain these variations. Using administrative data from the Veterans Health Administration, we found no differences in 1-year (5.2% vs 7.4%) and 5-year (23.3% vs 26.2%) mortality for blacks vs whites. Conclusion: Among patients with acute myocardial infarction or unstable angina, variation in clinical factors using RAND appropriateness criteria for procedures explained some, but not all, racial differences in coronary revascularization use. C1 VA Pittsburgh Hlth Care Syst, Gen Internal Med Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA USA. Univ Calif Los Angeles, Sch Med, W Los Angeles Vet Affairs Med Ctr, VA Ctr Study Healthcare Provider Behav, Los Angeles, CA USA. Med Coll Wisconsin, Milwaukee Vet Affairs Med Ctr, Div Gen Internal Med, Milwaukee, WI 53226 USA. Univ Alabama, Birmingham Vet Affairs Med Ctr, Div Geriatr, Birmingham, AL USA. Univ Penn, Philadelphia Vet Affairs Med Ctr, Div Gen Internal Med, Philadelphia, PA 19104 USA. RP Conigliaro, J (reprint author), VA Pittsburgh Hlth Care Syst, Gen Internal Med Sect, Locat 11E-120,Univ Dr C, Pittsburgh, PA 15240 USA. RI Allman, Richard/D-5964-2011 NR 34 TC 74 Z9 75 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD MAY 8 PY 2000 VL 160 IS 9 BP 1329 EP 1335 DI 10.1001/archinte.160.9.1329 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 312DJ UT WOS:000086927700014 PM 10809037 ER PT J AU Jiang, QS Li, JQ Dubroff, R Ahn, YJ Foskett, JK Engelhardt, J Kleyman, TR AF Jiang, QS Li, JQ Dubroff, R Ahn, YJ Foskett, JK Engelhardt, J Kleyman, TR TI Epithelial sodium channels regulate cystic fibrosis transmembrane conductance regulator chloride channels in Xenopus oocytes SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID CELL-SURFACE EXPRESSION; NA+ CHANNEL; ARGININE-VASOPRESSIN; ALPHA-SUBUNITS; GAMMA-SUBUNITS; BETA-SUBUNITS; CL CHANNELS; A6 CELLS; CFTR; INHIBITION AB The cystic fibrosis transmembrane conductance regulator (CFTR), in addition to its well defined Cl- channel properties, regulates other ion channels, CFTR inhibits epithelial Na+ channel (ENaC) currents in many epithelial and nonepithelial cells. Because modulation of net NaCl reabsorption has important implications in extracellular fluid volume homeostasis and airway fluid volume and composition, we investigated whether this regulation was reciprocal by examining whether ENaC regulates CFTR, Co-expression of human (h) CFTR and mouse (m) alpha beta gamma ENaC in Xenopus oocytes resulted in a significant, 3.7-fold increase in whole-cell hCFTR Cl- conductance compared with oocytes expressing hCFTR alone, The forskolin/3-isobutyl-1-methylxanthine-stimulated whole-cell conductance in hCFTR-mENaC co-injected oocytes was amiloride-insensitive, indicating an inhibition of mENaC following hCFTR activation, and it was blocked by DPC (diphenylamine-2-carboxylic acid) and was DIDS (4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid)-insensitive. Enhanced hCFTR Cl- conductance was also observed when either the alpha- or beta-subunit of mENaC was co-expressed with hCFTR, but this was not seen when CFTR was co-expressed with the gamma-subunit of mENaC. Single Cl- channel analyses showed that both CFTR Cl- channel open probability and the number of CFTR Cl- channels detected per patch increased when hCFTR was co-expressed with alpha beta gamma mENaC. We conclude that in addition to acting as a regulator of ENaC, CFTR activity is regulated by ENaC. C1 Univ Penn, Div Renal, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Dept Physiol, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Iowa, Dept Anat, Iowa City, IA 52242 USA. RP Kleyman, TR (reprint author), Univ Penn, Div Renal, Dept Med, 700 CRB,415 Curie Blvd, Philadelphia, PA 19104 USA. OI Foskett, J. Kevin/0000-0002-8854-0268 FU NIDDK NIH HHS [DK56305] NR 50 TC 49 Z9 50 U1 0 U2 3 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD MAY 5 PY 2000 VL 275 IS 18 BP 13266 EP 13274 DI 10.1074/jbc.275.18.13266 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 312CH UT WOS:000086925300018 PM 10788432 ER PT J AU Kanabrocki, EL Third, JLHC Ryan, MD Nemchausky, BA Shirazi, P Scheving, LE McCormick, JB Hermida, RC Bremner, WF Hoppensteadt, DA Fareed, J Olwin, JH AF Kanabrocki, EL Third, JLHC Ryan, MD Nemchausky, BA Shirazi, P Scheving, LE McCormick, JB Hermida, RC Bremner, WF Hoppensteadt, DA Fareed, J Olwin, JH TI Circadian relationship of serum uric acid and nitric oxide SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID EXPERIMENTAL ALLERGIC ENCEPHALOMYELITIS; MULTIPLE-SCLEROSIS; PEROXYNITRITE C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. Swedish Covenant Hosp, Chicago, IL USA. Univ Vigo, Vigo, Spain. MacNeal Cardiol Grp, Berwyn, IL USA. Loyola Univ, Med Ctr, Maywood, IL 60153 USA. Vasc Dis Res Fdn, Skokie, IL USA. RP Kanabrocki, EL (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. NR 6 TC 62 Z9 62 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 3 PY 2000 VL 283 IS 17 BP 2240 EP 2241 DI 10.1001/jama.283.17.2240 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 307UB UT WOS:000086671600027 PM 10807381 ER PT J AU Casarett, D Karlawish, JHT Sugarman, J AF Casarett, D Karlawish, JHT Sugarman, J TI Determining when quality improvement initiatives should be considered research - Proposed criteria and potential implications SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID HEALTH-SERVICES RESEARCH; NUCHAL-TRANSLUCENCY; SATISFACTION; DELIVERY; CONDUCT; PROJECT; CARE AB Quality improvement initiatives have become a major force in shaping health care, These initiatives are diverse but share a common goal of generating knowledge that will guide improvements in health care, Although quality improvement occupies an uncertain territory between clinical care and research, this difference is extremely important, If a quality improvement initiative is research, federal regulations require a variety of procedures that must be followed to protect the human subjects involved. Conversely, if the same initiative is not research, the regulations outlining these procedures are not applicable. This article proposes 2 criteria to determine whether a quality improvement initiative should be reviewed as research, Such an initiative should be reviewed and regulated as research if (1) the majority of patients involved are not expected to benefit directly from the knowledge to be gained or (2) if additional risks or burdens are imposed to make the results generalizable. Implementation of these criteria offers the possibility that the rights and interests of those who participate in quality improvement initiatives will be protected. C1 Univ Penn, Ctr Bioeth, Inst Aging, Philadelphia, PA 19104 USA. Univ Penn, Div Geriatr, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. Alzheimers Dis Ctr, Philadelphia, PA USA. Duke Univ, Dept Med, Durham, NC USA. Duke Univ, Dept Philosophy, Durham, NC USA. Duke Univ, Ctr Study Med Eth & Humanities, Durham, NC USA. RP Casarett, D (reprint author), Univ Penn, Ctr Bioeth, Inst Aging, 3615 Chestnut St, Philadelphia, PA 19104 USA. NR 18 TC 103 Z9 103 U1 2 U2 6 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 3 PY 2000 VL 283 IS 17 BP 2275 EP 2280 DI 10.1001/jama.283.17.2275 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 307UB UT WOS:000086671600036 PM 10807388 ER PT J AU Williams, JW Mulrow, CD Chiquette, E Noel, PH Aguilar, C Cornell, J AF Williams, JW Mulrow, CD Chiquette, E Noel, PH Aguilar, C Cornell, J TI A systematic review of newer pharmacotherapies for depression in adults: Evidence report summary SO ANNALS OF INTERNAL MEDICINE LA English DT Review ID SEROTONIN REUPTAKE INHIBITORS; NATIONAL-COMORBIDITY-SURVEY; RANDOMIZED CLINICAL-TRIALS; LONG-TERM TREATMENT; ST-JOHNS WORT; PRIMARY-CARE; DOUBLE-BLIND; MAJOR DEPRESSION; TRICYCLIC ANTIDEPRESSANTS; DISCONTINUATION RATES AB Background: Depressive disorders are persistent, recurring illnesses that cause great suffering for patients and their families. Purpose: To evaluate the benefits and adverse effects of newer pharmacotherapies and herbal treatments for depressive disorders in adults and adolescents. Data Sources: English-language and non-English-language literature from 1980 to January 1998 was identified from a specialized registry of controlled trials, meta-analyses, and experts. Study Selection: Randomized trials evaluating newer antidepressants (such as serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and St. John's wort) that reported clinical outcomes were selected. Data Extraction: Two persons independently abstracted data that were then synthesized descriptively; some data were pooled by using a random-effects model. Data Synthesis: Of 315 eligible trials, most evaluated antidepressants in adults with major depression, were conducted among outpatients, and examined acute-phase treatment. Newer antidepressants were more effective than placebo for major depression (relative benefit, 1.6 [95% CI, 1.5 to 1.7]) and dysthymia (relative benefit, 1.7 [CI, 1.3 to 2.3]). They were effective among older adults and primary care patients. Efficacy did not differ among newer agents or between newer and older agents. Hypericum (St. John's wort) was more effective than placebo for mild to moderate depression (risk ratio, 1.9 [Cl, 1.2 to 2.8]), but publication bias may have inflated the estimate of benefit. Newer and older antidepressants did not differ for overall discontinuation rates, but side effect profiles varied significantly. Data were insufficient for determining the efficacy of newer antidepressants for subsyndromal depression, depression with coexisting medical or psychiatric illness, or depression in adolescents. Conclusions: Newer antidepressants are clearly effective in treating depressive disorders in diverse settings. Because of similar efficacy, both newer and older antidepressants should be considered when making treatment decisions. Better information is urgently needed on the efficacy of newer antidepressants in patients with nonmajor depression and in special populations, including adolescents. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio Evidence Based Practice Ctr, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, Kerrville, TX USA. RP Williams, JW (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio Evidence Based Practice Ctr, 7703 Floyd Curl Dr,Mail Code 7879, San Antonio, TX 78229 USA. RI Williams, Jr., John/A-3696-2008 OI Williams, Jr., John/0000-0002-5267-5558 FU PHS HHS [290-97-0012] NR 114 TC 236 Z9 242 U1 5 U2 25 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD MAY 2 PY 2000 VL 132 IS 9 BP 743 EP 756 PG 14 WC Medicine, General & Internal SC General & Internal Medicine GA 308VT UT WOS:000086734100010 PM 10787370 ER PT J AU Prabhu, SD Chandrasekar, B Murray, DR Freeman, GL AF Prabhu, SD Chandrasekar, B Murray, DR Freeman, GL TI beta-adrenergic blockade in developing heart failure - Effects on myocardial inflammatory cytokines, nitric oxide, and remodeling SO CIRCULATION LA English DT Article DE heart failure; adrenergic beta antagonists; cytokines; nitric oxide; myocardial infarction ID NECROSIS-FACTOR-ALPHA; RAT CARDIAC MYOCYTES; FAILING HUMAN HEART; EXPRESSION; STIMULATION; SYNTHASE; DYSFUNCTION; INFARCTION; INHIBITION; MECHANISM AB Background-Whether beta-adrenergic blockade modulates myocardial expression of inflammatory cytokines and nitric oxide (NO) in heart failure is unclear. Methods and Results-We administered oral metoprolol or no therapy to rats for 12 weeks after large myocardial infarction and subsequently examined left ventricular (LV) remodeling; myocardial tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, and IL-6 expression; and NO. In untreated rats, echocardiography revealed significant (P<0.001) LV dilatation and systolic dysfunction compared with sham. Papillary muscle studies revealed isoproterenol hyporesponsiveness to be unaltered by NO synthase (NOS) inhibition. Circulating NO metabolites were undetectable. In noninfarcted myocardium, although inducible NOS (iNOS) mRNA was absent, TNF-alpha, IL-1 beta, and IL-6 mRNA and protein were markedly elevated compared with sham (P<0.001), with 2-fold higher expression (P<0.025) of IL-6 compared with TNF-alpha or IL-1 beta. Metoprolol administration starting 48 hours after infarction (1) attenuated (P<0.02) LV dilatation and systolic dysfunction, (2) preserved isoproterenol responsiveness (P<0.025) via NO-independent mechanisms, and (3) reduced myocardial gene expression and protein production of TNF-alpha and IL-1 beta (P<0.025) but not IL-6, which remained high. Conclusions-During heart failure development, adrenergic activation contributes to increased myocardial expression of TNF-alpha and IL-1 beta but not TL-6, and one mechanism underlying the beneficial effects of beta-adrenergic blockade may involve attenuation of TNF-alpha and IL-1 beta expression independent of iNOS and NO. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX USA. RP Prabhu, SD (reprint author), Univ Louisville, Dept Med Cardiol, ACB, 3rd Floor,550 S Jackson St, Louisville, KY 40292 USA. RI Prabhu, Sumanth/D-5223-2009 NR 28 TC 181 Z9 208 U1 2 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD MAY 2 PY 2000 VL 101 IS 17 BP 2103 EP 2109 PG 7 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 310EH UT WOS:000086813200016 PM 10790354 ER PT J AU Sarosiek, J Jensen, RT Maton, PN Peura, DA Harlow, D Feng, TQ McCallum, RW Pisegna, JR AF Sarosiek, J Jensen, RT Maton, PN Peura, DA Harlow, D Feng, TQ McCallum, RW Pisegna, JR TI Salivary and gastric epidermal growth factor in patients with Zollinger-Ellison Syndrome: Its protective potential SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID GASTROESOPHAGEAL REFLUX DISEASE; HELICOBACTER-PYLORI; ESOPHAGEAL MUCOSA; ACID; SECRETION; RELEASE; HUMANS; ESOPHAGOPROTECTION; CYTOPROTECTION; PROSTAGLANDINS AB OBJECTIVE: Evidence is accumulating that epidermal growth factor (EGF) is a major molecule contributing to the maintenance of the integrity of the upper alimentary tract mucosa before and after injury by acid and pepsin. Patients with Zollinger-Ellison Syndrome (ZES) typically have hypersecretion of acid and pepsin; however, the concentration and rate of secretion of salivary and gastric EGF that could counteract these potentially aggressive factors are unknown. Accordingly, this study was conducted to determine whether EGF affords mucosal protection in ZES patients. METHODS: The concentration and output of salivary (sEGF) and gastric epidermal growth factor (gEGF) were measured in eight patients with ZES and the results compared to those in 17 patients with nonulcer dyspepsia (NUD), serving as a control group. All patients had normal esophageal and gastric mucosa as determined by endoscopy. Total saliva was collected during l-h parafilm- and l-h pentagastrin/parafilm-stimulated conditions, as well as basal and pentagastrin-stimulated gastric juice. The concentration and output of EGF were determined by radioimmunoassay. RESULTS: The concentration of EGF in saliva collected from ZES patients after parafilm chewing was significantly higher compared to that in NUD patients (4.61 +/- 0.59 vs 2.75 +/- 0.50 ng/ml, p < 0.05). The concentration of EGF in saliva collected after pentagastrin stimulation in ZES patients was also significantly higher than in NUD patients (4.37 +/- 0.73 vs 2.22 +/- 0.37 ng/ml, p < 0.05). Salivary EGF output during parafilm chewing in ZES and NUD were similar (68 +/- 6.4 vs 109 +/- 25.2 ng/h). Salivary EGF output after administration of pentagastrin in ZES and NUD was also similar (66 +/- 6.1 vs 132 +/- 45.4 ng/h). Basal EGF output in the gastric juice of patients with ZES was 3-fold higher than in patients with NUD (801 +/- 73 la 271 +/- 32 ng/h, p < 0.01). Pentagastrin-stimulated EGF output was similar in both groups (705 +/- 92 Is 675 +/- 168 ng/h). CONCLUSIONS: Patients with ZES have a significantly higher EGF concentration in saliva and EGF output in basal gastric juice. This elevated content of salivary and gastric EGF in ZES patients may ploy a protective role in preventing the development of reflux esophagitis and gastric ulcer under the impact of gastric acid and pepsin hypersecretion. (C) 2000 by Am. Cell. of Gastroenterology. C1 Univ Calif Los Angeles, W Los Angeles Vet Affairs Med Ctr, Training Program Gastroenterol, Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Kansas, Med Ctr, Kansas City, KS 66103 USA. NIH, Digest Dis Branch, Bethesda, MD 20892 USA. Univ Virginia, Hlth Sci Ctr, Charlottesville, VA 22903 USA. RP Pisegna, JR (reprint author), Univ Calif Los Angeles, W Los Angeles Vet Affairs Med Ctr, Training Program Gastroenterol, Vet Affairs Greater Los Angeles Hlth Care Syst, Bldg 115,Room 316, Los Angeles, CA 90073 USA. NR 42 TC 14 Z9 14 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD MAY PY 2000 VL 95 IS 5 BP 1158 EP 1165 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 310WW UT WOS:000086853300010 PM 10811321 ER PT J AU Chey, WD Metz, DC Shaw, S Kearney, D Montague, J Murthy, U AF Chey, WD Metz, DC Shaw, S Kearney, D Montague, J Murthy, U TI Appropriate timing of the C-14-urea breath test to establish eradication of Helicobacter pylori infection SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID SUPPRESSION; DYSPEPSIA; ACCURACY AB OBJECTIVE: The aim of this study was to determine the performance characteristics of the C-14-urea breath test (UBT) performed 2 wk after the completion of therapy for Helicobacter pylori using a 4 to 6 wk study as the gold standard. METHODS: Patients with active Helicobacter pylori infection at four medical centers received proton pump inhibitor-based triple or quadruple therapy for 10-14 days. Patients underwent the C-14-UBT 2 and 4-6 wk after the completion of therapy. A positive test was defined as (CO2)-C-14 excretion of >200 dpm, a negative test as <50 dpm, and an equivocal test as >50 but <200 dpm. Performance characteristics of the 2-wk UBT were calculated using the 4 to 6-wk result as a gold standard. RESULTS: Eighty-five patients were enrolled and 82 patients (mean +/- SD age, 62 +/- 15 yr; 15 women) completed the protocol. Four patients had equivocal UBT results and were excluded from the analysis. Of the 78 patients, 68 (87%) had a negative 4 to 6-wk UBT. The 2-week UBT yielded a sensitivity of 90% (95% confidence interval 72-100%), specificity of 99% (97-100%), and accuracy of 97% (93-100%). In patients with a persistently positive UBT, (CO2)-C-14 excretion at 2 wk was significantly lower than at 4-6 wk after therapy (p = 0.03). CONCLUSIONS: A UBT performed 2 wk after therapy yielded results comparable to 4 to 6 wk testing. Further studies to evaluate the optimal time of confirmatory testing in the age of more effective proton pump inhibitor-based triple therapies are warranted. (C) 2000 by Am. Cell. of Gastroenterology. C1 Univ Michigan, Med Ctr, Ann Arbor, MI 48109 USA. Univ Penn Hlth Syst, Philadelphia, PA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. VA Med Ctr, Syracuse, NY USA. RP Chey, WD (reprint author), 3912 Taubman Ctr, Box 0362, Ann Arbor, MI 48109 USA. NR 15 TC 14 Z9 14 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD MAY PY 2000 VL 95 IS 5 BP 1171 EP 1174 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 310WW UT WOS:000086853300012 PM 10811323 ER PT J AU Santhosh-Kumar, CR Bisping, JS Kick, SD Deutsch, JC Kolhouse, JF AF Santhosh-Kumar, CR Bisping, JS Kick, SD Deutsch, JC Kolhouse, JF TI Folate sufficient subjects do not accumulate additional folates during supplementation SO AMERICAN JOURNAL OF HEMATOLOGY LA English DT Article DE folate assays; insufficiency; deficiency ID HOMOCYSTEINE; WOMEN; SERUM; ACID AB In a double-blinded placebo-controlled trial of folic acid supplementation in 82 alcoholic subjects, it was found that whole blood folate levels, determined by a mass spectrometric method, do not increase in subjects whose baseline folate levels are above the third quartile (folate sufficiency). Since a state of folate sufficiency can now be identified, a recommended daily allowance (RDA) for folate can be determined using objective means, Am. J. Hematol, 64:71-72, 2000. (C) 2000 Wiley-Liss, Inc. C1 Univ Colorado, Hlth Sci Ctr, Div Hematol, Denver, CO 80262 USA. Denver VAH, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Div Gastroenterol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Div Gen Internal Med, Denver, CO 80262 USA. Royal Hosp, Dept Med, Muscat, Oman. RP Kolhouse, JF (reprint author), Univ Colorado, Hlth Sci Ctr, Div Hematol, 4200 E 9th Ave,B-170, Denver, CO 80262 USA. FU NIDDK NIH HHS [R44 DK50519] NR 10 TC 4 Z9 4 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0361-8609 J9 AM J HEMATOL JI Am. J. Hematol. PD MAY PY 2000 VL 64 IS 1 BP 71 EP 72 DI 10.1002/(SICI)1096-8652(200005)64:1<71::AID-AJH13>3.0.CO;2-Z PG 2 WC Hematology SC Hematology GA 306HB UT WOS:000086590300013 PM 10815792 ER PT J AU Grimm, C AF Grimm, C TI Teaching managed care principles: We need to do better SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Editorial Material ID RESIDENTS; MEDICINE; ENVIRONMENT; SYSTEMS C1 VA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Los Angeles, CA USA. RP Grimm, C (reprint author), St Vincents Med Ctr, 2800 Main St,Level 8, Bridgeport, CT 06606 USA. NR 13 TC 0 Z9 0 U1 0 U2 0 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD MAY PY 2000 VL 6 IS 5 BP 625 EP 627 PG 3 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 313XG UT WOS:000087024500008 PM 10977470 ER PT J AU Esteban, A Anzueto, A Alia, I Gordo, F Apezteguia, C Palizas, F Cide, D Goldwaser, R Soto, L Bugedo, G Rodrigo, C Pimentel, J Raimondi, G Tobin, MJ AF Esteban, A Anzueto, A Alia, I Gordo, F Apezteguia, C Palizas, F Cide, D Goldwaser, R Soto, L Bugedo, G Rodrigo, C Pimentel, J Raimondi, G Tobin, MJ CA Mech Ventilation Int Study Grp TI How is mechanical ventilation employed in the intensive care unit? An international utilization review SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Article ID RESPIRATORY-DISTRESS-SYNDROME; END-EXPIRATORY PRESSURE; OBSTRUCTIVE PULMONARY-DISEASE; ACUTE EXACERBATION; NATIONAL SURVEY; TIDAL VOLUME; LUNG-DISEASE; MORTALITY; FAILURE; DEFINITIONS AB A 1-d point-prevalence study was performed with the aim of describing the characteristics of conventional mechanical ventilation in intensive care units ICUs from North America, South America Spain, and Portugal. The study involved 412 medical-surgical ICUs and 1,638 patients receiving mechanical ventilation at the moment of the study. The main outcome measures were characterization of the indications for initiation of mechanical ventilation, the artificial airways used to deliver mechanical ventilation, the ventilator modes and settings, and the methods of weaning. The median age of the study patients was 67 yr, and the median duration of mechanical ventilation at the time of the study was 7 d. Common indications for the initiation of mechanical ventilation included acute respiratory failure (66%), acute exacerbation of chronic obstructive pulmonary disease (13%), coma (10%), and neuromuscular disorders (10%). Mechanical ventilation was delivered via an endotracheal tube in 75% of patients, a tracheostomy in 24%, and a facial mask in 1%. Ventilator modes consisted of assist/control ventilation in 47% of patients and 46% were ventilated with synchronized intermittent mandatory ventilation, pressure support, or the combination of both. The median tidal volume setting was 9 ml/kg in patients receiving assist/control and the median setting of pressure support was 18 cm H2O. Positive end-expiratory pressure was not employed in 31% of patients. Method of weaning varied considerably from country to country, and even within a country several methods were in use. We conclude that the primary indications for mechanical ventilation and the ventilator settings were remarkably similar across countries, but the selection of modes of mechanical ventilation and methods of weaning varied considerably from country to country. C1 Univ Madrid, Hosp Getafe, Unidad Cuidados Intensivos, Madrid 28905, Spain. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. Hosp Profesor Posadas, Buenos Aires, DF, Argentina. Clin Bazterr, Buenos Aires, DF, Argentina. Univ Fed Rio de Janeiro, Hosp Clementino Fraga Filho, Rio De Janeiro, Brazil. Inst Nacl Enfermedades Resp & Cirugia Torac, Santiago, Chile. Pontificia Univ Catolica Chile, Santiago, Chile. Asociac Espanola Primera Socorros Mutuos, Montevideo, Uruguay. Hosp Univ Coimbra, Coimbra, Portugal. FLENI, Buenos Aires, DF, Argentina. Loyola Univ, Chicago, IL 60611 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. RP Esteban, A (reprint author), Univ Madrid, Hosp Getafe, Unidad Cuidados Intensivos, Carretera Toledo Km 12-500, Madrid 28905, Spain. NR 35 TC 338 Z9 369 U1 0 U2 7 PU AMER LUNG ASSOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019 USA SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD MAY PY 2000 VL 161 IS 5 BP 1450 EP 1458 PG 9 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 312LU UT WOS:000086945400012 PM 10806138 ER PT J AU Cooper, JAD AF Cooper, JAD TI Pulmonary fibrosis - Pathways are slowly coming into light SO AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY LA English DT Article ID GROWTH-FACTOR-BETA; P53 EXPRESSION; FAS LIGAND; BLEOMYCIN; MICE; APOPTOSIS; COLLAGEN; STIMULATION; INDUCTION; DISEASE C1 Univ Alabama, Div Pulm Allergy & Crit Care Med, Univ Stn, Pulm Sect, Birmingham, AL 35294 USA. Birmingham VAMC, Pulm Sect, Birmingham, AL USA. RP Cooper, JAD (reprint author), Univ Alabama, Div Pulm Allergy & Crit Care Med, Univ Stn, Pulm Sect, Birmingham, AL 35294 USA. NR 32 TC 53 Z9 59 U1 0 U2 0 PU AMER LUNG ASSOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019 USA SN 1044-1549 J9 AM J RESP CELL MOL JI Am. J. Respir. Cell Mol. Biol. PD MAY PY 2000 VL 22 IS 5 BP 520 EP 523 PG 4 WC Biochemistry & Molecular Biology; Cell Biology; Respiratory System SC Biochemistry & Molecular Biology; Cell Biology; Respiratory System GA 313EC UT WOS:000086986500003 PM 10783121 ER PT J AU Dubinett, SM Batra, RK Miller, PW Sharma, S AF Dubinett, SM Batra, RK Miller, PW Sharma, S TI Tumor antigens in thoracic malignancy SO AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY LA English DT Article ID CYTOTOXIC T-LYMPHOCYTES; PULSED DENDRITIC CELLS; HUMAN LUNG-CANCER; IN-VIVO; GENE-THERAPY; B-CELLS; PROSTAGLANDIN E(2); IMMUNE RECOGNITION; PRESENTING CELLS; AUTOLOGOUS TUMOR C1 Univ Calif Los Angeles, Sch Med, Div Pulm & Crit Care Med,Wadsworth Pulm Lab, Jonsson Comprehens Canc Ctr,Dept Med, Los Angeles, CA 90095 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. RP Dubinett, SM (reprint author), Univ Calif Los Angeles, Sch Med, Div Pulm & Crit Care Med,Wadsworth Pulm Lab, Jonsson Comprehens Canc Ctr,Dept Med, 37-131 Ctr Hlth Sci,10833 LeConte Ave, Los Angeles, CA 90095 USA. NR 75 TC 5 Z9 5 U1 0 U2 0 PU AMER LUNG ASSOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019 USA SN 1044-1549 J9 AM J RESP CELL MOL JI Am. J. Respir. Cell Mol. Biol. PD MAY PY 2000 VL 22 IS 5 BP 524 EP 527 PG 4 WC Biochemistry & Molecular Biology; Cell Biology; Respiratory System SC Biochemistry & Molecular Biology; Cell Biology; Respiratory System GA 313EC UT WOS:000086986500004 PM 10783122 ER PT J AU Batra, RK Dubinett, SM Henkle, BW Sharma, S Gardner, BK AF Batra, RK Dubinett, SM Henkle, BW Sharma, S Gardner, BK TI Adenoviral gene transfer is inhibited by soluble factors in malignant pleural effusions SO AMERICAN JOURNAL OF RESPIRATORY CELL AND MOLECULAR BIOLOGY LA English DT Article ID FIBROSIS AIRWAY EPITHELIA; PENTON BASE PROTEIN; I CLINICAL-TRIAL; IMMUNE-RESPONSES; LUNG-CANCER; ADENOASSOCIATED VIRUS; MOLECULAR MEDICINE; HELPER VIRUS; MOUSE-LIVER; DELIVERY AB Direct in vivo gene delivery is a prerequisite for many gene therapy strategies; however, efficacy has been limited by a lack of therapeutic gene transfer. in studying intrapleural malignancy as a model for the gene therapy of non-small cell lung cancer, we previously identified soluble chondroitin sulfate-proteoglycans/glycosaminoglycans (CS-PG/GAGs) in malignant pleural effusions (MPE) as factors that inhibit retroviral vector (RV) transduction. Similarly, we have observed inhibition to gene transfer in the fluid component of MPE using adenoviral (Ad) vectors. Analyses indicate that the factors responsible for the block are filterable, soluble, titrable, and heat stable (56 degrees C). Passage through microporous membranes fractionates the inhibitory factors into large (> 100 kD) components of the effusions. In contrast to RV transduction, hyaluronic acid or CS-PG/GAGs are not the inhibitors because the block is not reversed by pretreatment of the effusions with mammalian hyaluronidase, and exogenous addition of GAGs into the transduction media does not diminish Ad transduction. In considering the mechanism of action of the inhibitory factors, we observe that Ad entry, and specifically the binding of radiolabeled Ad to its target cell, is inhibited in the presence of MPE. Ad internalization may also be impaired; however, these studies exclude soluble fibronectin in MPE as a competitive inhibitor of Ad transduction. Lastly, sepharose A-mediated immunoglobulin depletion of MPE only partially reverses the block, and significant inhibition to Ad gene transfer persists at lower adenovirus:target cell ratios. Identifying the structural and functional basis for inhibition to Ad gene transfer may yield specific strategies to enable better in vivo translation of gene therapy approaches. C1 Univ Calif Los Angeles, Sch Med, Div Pulm & Crit Care Med, Vet Adm Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Wadsworth Pulm Immunol Lab, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP Batra, RK (reprint author), Univ Calif Los Angeles, Sch Med, Div Pulm & Crit Care Med, Vet Adm Greater Los Angeles Hlth Care Syst, 111Q,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. FU NCI NIH HHS [R01 CA078654-01A1, R01CA78654] NR 45 TC 13 Z9 14 U1 0 U2 0 PU AMER LUNG ASSOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019 USA SN 1044-1549 J9 AM J RESP CELL MOL JI Am. J. Respir. Cell Mol. Biol. PD MAY PY 2000 VL 22 IS 5 BP 613 EP 619 PG 7 WC Biochemistry & Molecular Biology; Cell Biology; Respiratory System SC Biochemistry & Molecular Biology; Cell Biology; Respiratory System GA 313EC UT WOS:000086986500016 PM 10783134 ER PT J AU Rabkin, JM Oroloff, SL Corless, CL Benner, KG Flora, KD Rosen, HR Olyaei, AJ AF Rabkin, JM Oroloff, SL Corless, CL Benner, KG Flora, KD Rosen, HR Olyaei, AJ TI Association of fungal infection and increased mortality in liver transplant recipients SO AMERICAN JOURNAL OF SURGERY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the North-Pacific-Surgical-Association CY NOV 12-13, 1999 CL VANCOUVER, CANADA SP N Pacific Surg Assoc ID AMPHOTERICIN-B AMBISOME; RISK-FACTORS; INVASIVE FUNGAL; CYTOMEGALOVIRUS DISEASE; PROPHYLAXIS; CANDIDA; FLUCONAZOLE; BACTERIAL; TRIAL AB BACKGROUND: Invasive fungal infection is associated with increased morbidity and mortality following orthotopic liver transplantation (OLTx). Understanding the risk factors associated with fungal infection may facilitate identification of high-risk patients and guide appropriate initiation of antifungal therapy. OBJECTIVES: The aim of this study was to determine the incidence of fungal infections, identify the most common fungal pathogens, and determine the risk factors associated with fungal infections and mortality in OLTx recipients. METHODS: Medical records from 96 consecutive OLTx in 90 American veterans (88 males, 2 females; mean age 48 years, range 32 to 67) performed from January 1994 to December 1997 were retrospectively reviewed for fungal infection in the first 120 days after transplantation. Infection was defined by positive cultures from either blood, urine (<105 CFU/mL), cerebrospinal or peritoneal fluid, and/or deep tissue specimens. Superficial fungal infection and asymptomatic colonization were excluded from study. All patients received cyclosporine, azathioprine, and prednisone as maintenance immunosuppressive therapy. Fungal prophylaxis consisted of oral clotrimazole (10 mg) troches, five times per day during the study period. RESULTS: Thirty-five patients (38%) had documented infection with one or more fungal pathogens, including Candida albicans (25 of 35; 71%), C torulopsis (7 of 35; 20%), C tropicalis (2 of 35; 6%), non-C albicans (2 of 35; 6%), Aspergillus fumigatus (4 of 35; 11%), and Cryptococcus neoformans (1 of 35; 3%). The crude survival for cases with or without fungal infection was 68% and 87%, respectively (P < 0.0001), The median intensive cave unit stay and overall duration of hospitalization were significantly longer for patients with fungal infection (P < 0.01). The mean time interval from transplantation to the development of fungal infection was 15 days (range 4 to 77) with a mean survival time from fungal infection to death of 21 days (range 3 to 64). Fungal infections occurred significantly more often in patients with renal insufficiency (serum creatinine > 2.5 mg/dL), biliary/vascular complications, and retransplantation, CONCLUSIONS: Fungal infections weve associated with increased morbidity and mortality following OLTx, with Candida albicans being the most common pathogen. Treatment strategies involving antifungal prophylaxis for high-risk patients and earlier initiation of antifungal therapy in cases of presumed infection ave warranted. (C) 2000 by Excerpta Medica, Inc. C1 Oregon Hlth Sci Univ, Dept Surg, Sect Liver Transplantat, Portland, OR 97201 USA. Portland Vet Affairs Med Ctr, Dept Pathol, Portland, OR USA. Portland Vet Affairs Med Ctr, Dept Med, Div Gastroenterol, Portland, OR USA. Portland Vet Affairs Med Ctr, Dept Pharm, Portland, OR USA. RP Rabkin, JM (reprint author), Sect Liver Pancreas Transplantat Hepatobiliary Su, 3181 SW Sam Jackson Pk Rd,L590, Portland, OR 97201 USA. NR 32 TC 57 Z9 82 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 USA SN 0002-9610 J9 AM J SURG JI Am. J. Surg. PD MAY PY 2000 VL 179 IS 5 BP 426 EP 430 DI 10.1016/S0002-9610(00)00366-4 PG 5 WC Surgery SC Surgery GA 341ZL UT WOS:000088620800020 PM 10930495 ER PT J AU Al-Abdely, HM Najvar, L Bocanegra, R Fothergill, A Loebenberg, D Rinaldi, MG Graybill, JR AF Al-Abdely, HM Najvar, L Bocanegra, R Fothergill, A Loebenberg, D Rinaldi, MG Graybill, JR TI SCH 56592, amphotericin B, or itraconazole therapy of experimental murine cerebral phaeohyphomycosis due to Ramichloridium obovoideum ("Ramichloridium mackenziei") SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID PHEOHYPHOMYCOSIS; INFECTIONS AB Ramichloridium obovoideum ("Ramichloridium makenziei") is a rare cause of lethal cerebral phaeohyphomycosis. It has been, so far, geographically restricted to the Middle East. BALB/c mice were inoculated with two strains of R. obovoideum intracranially. Therapy with amphotericin B, itraconazole, or the investigational triazole SCH 56592 was conducted for 10 days. Half the mice were monitored for survival and half were killed for determination of the fungal load in brain tissue. Recipients of SCH 56592 had significantly prolonged survival and lower brain fungal burden, and this result was found for mice infected with both of the fungal strains tested. Itraconazole reduced the brain fungal load in mice infected with one strain but not the other, while amphotericin B had no effect on brain fungal concentrations. This study indicates a possible role of SCH 56592 in the treatment of the serious cerebral phaeohyphomycosis due to R. obovoideum. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, San Antonio, TX 78284 USA. Audie L Murphy Vet Adm Hosp, San Antonio, TX 78284 USA. Schering Plough Corp, Res Inst, Kenilworth, NJ 07033 USA. RP Al-Abdely, HM (reprint author), King Faisal Specialist Hosp & Res Ctr, Dept Med MBC 46, POB 3354, Riyadh 2211, Saudi Arabia. NR 11 TC 46 Z9 48 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD MAY PY 2000 VL 44 IS 5 BP 1159 EP 1162 DI 10.1128/AAC.44.5.1159-1162.2000 PG 4 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 306YC UT WOS:000086625400007 PM 10770745 ER PT J AU Perea, S Pennick, GJ Modak, A Fothergill, AW Sutton, DA Sheehan, DJ Rinaldi, MG AF Perea, S Pennick, GJ Modak, A Fothergill, AW Sutton, DA Sheehan, DJ Rinaldi, MG TI Comparison of high-performance liquid chromatographic and microbiological methods for determination of voriconazole levels in plasma SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID INVASIVE PULMONARY ASPERGILLOSIS; TRIAZOLE ANTIFUNGAL AGENTS; IN-VITRO ACTIVITIES; EXPERIMENTAL-MODEL; FLUCONAZOLE; UK-109,496; ITRACONAZOLE; CANDIDA; EFFICACY; PATHOGENS AB A new selective high-performance liquid chromatography (HPLC) method with UV detection for the determination of the investigational triazole voriconazole in human plasma by using acetonitrile precipitation followed by reverse-phase HPLC on a C-18 column was compared with a simple agar well diffusion bioassay method with Candida kefyr ATCC 46764 as the assay organism. Pooled plasma was used to prepare standard and control samples for both methods. The results of analyses with spiked serum samples (run as unknowns) were concordant by the bioassay and HPLC methods, with expected values being obtained. HPLC demonstrated an improved precision (3.47 versus 12.12%) and accuracy (0.81 versus 1.28%) compared to those of the bioassay method. The range of linearity obtained by both methods (from 0.2 to 10 mu g/ml for HPLC and from 0.25 to 20 mu g/ml for the bioassay) includes the range of concentrations of voriconazole (from 1.2 to 4.7 mu g/ml) which are considered clinically relevant. Although either methodology could be used for the monitoring of patient therapy, the smaller variability observed with HPLC compared to that observed with the bioassay favors the use of HPLC for pharmacokinetic studies. C1 Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audir Murphy Div, San Antonio, TX USA. Pfizer Inc, Pfizer Pharmaceut Grp, New York, NY USA. RP Perea, S (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, 7703 Floyd Curl Dr,Mail Code 7881, San Antonio, TX 78229 USA. NR 21 TC 76 Z9 79 U1 0 U2 8 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD MAY PY 2000 VL 44 IS 5 BP 1209 EP 1213 DI 10.1128/AAC.44.5.1209-1213.2000 PG 5 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 306YC UT WOS:000086625400015 PM 10770753 ER PT J AU Park, GH McNeil, MR Tompkins, CA AF Park, GH McNeil, MR Tompkins, CA TI Reliability of the five-item revised token test for individuals with aphasia SO APHASIOLOGY LA English DT Article; Proceedings Paper CT 29th Clinical Aphasiology Conference (CAC) CY JUN, 1999 CL KEY WEST, FLORIDA AB Two trained raters and 11 aphasic subjects were used to evaluate test-retest, interrater and intra-rater reliabilities of the Five-Item (55 total) Revised Token Test (Arvedson et al. 1985). Results revealed high reliability for overall mean scores, and moderate to high reliability for individual subtests and linguistic elements scores. Standard error of measurement (SEM) values were also determined based on the aphasic subjects' data. A discrepancy between large SEM values and the mean absolute difference value suggests that further evaluation of SEM is required with a larger sample size. Results suggest that the Five-Item Revised Token Test is a reliable instrument to assess auditory processing impairments in adults with aphasia. Given the time constraints experienced in clinical and research settings, this assessment tool is useful due to its validity, reliability, and brevity. C1 Univ Pittsburgh, Dept Commun Sci & Disorders, Pittsburgh, PA 15260 USA. VA Pittsburgh Hlth Care Syst, Aphasia Rehabil Res Lab & Clin, Pittsburgh, PA USA. RP Park, GH (reprint author), Vet Adm Med Ctr, 7180 Highland Dr, Pittsburgh, PA 15206 USA. NR 15 TC 13 Z9 13 U1 0 U2 1 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0268-7038 J9 APHASIOLOGY JI Aphasiology PD MAY-JUN PY 2000 VL 14 IS 5-6 BP 527 EP 535 PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 316ME UT WOS:000087170400008 ER PT J AU Doyle, PJ McNeil, MR Park, G Goda, A Rubenstein, E Spencer, K Carroll, B Lustig, A Szwarc, L AF Doyle, PJ McNeil, MR Park, G Goda, A Rubenstein, E Spencer, K Carroll, B Lustig, A Szwarc, L TI Linguistic validation of four parallel forms of a story retelling procedure SO APHASIOLOGY LA English DT Article; Proceedings Paper CT 29th Clinical Aphasiology Conference (CAC) CY JUN, 1999 CL KEY WEST, FLORIDA ID CONNECTED SPEECH; APHASIA; ADULTS AB This study reports the development and validation of four parallel forms of a story retelling procedure. The equivalency of forms was based on the performance of 15 adults with aphasia on 12 operationally defined productive language variables including measures of (a) verbal productivity, (b) information content, (c) grammatical well-formedness, (d) phoneme production, and (e) verbal disruptions. The results revealed no significant differences among the four forms of the test for any of the dependent measures, and strong, positive and significant correlations among forms for 11 of the 12 dependent measures. These results suggest that a wide variety of productive language variables can be reliably measured using parallel forms of the story-retelling procedure described herein. C1 VA Pittsburgh Healthcare Syst, Aphasia Rehabil Res Lab & Clin, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. Univ Pittsburgh, Dept Commun Sci & Disorders, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Off Measurement & Evaluat Teaching, Pittsburgh, PA 15260 USA. RP Doyle, PJ (reprint author), Vet Adm Med Ctr, 7180 Highland Dr, Pittsburgh, PA 15206 USA. NR 23 TC 23 Z9 23 U1 0 U2 2 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0268-7038 J9 APHASIOLOGY JI Aphasiology PD MAY-JUN PY 2000 VL 14 IS 5-6 BP 537 EP 549 PG 13 WC Clinical Neurology SC Neurosciences & Neurology GA 316ME UT WOS:000087170400009 ER PT J AU Spencer, KA Doyle, PJ McNeil, MR Wambaugh, JL Park, G Carroll, B AF Spencer, KA Doyle, PJ McNeil, MR Wambaugh, JL Park, G Carroll, B TI Examining the facilitative effects of rhyme in a patient with output lexicon damage SO APHASIOLOGY LA English DT Article; Proceedings Paper CT 29th Clinical Aphasiology Conference (CAC) CY JUN, 1999 CL KEY WEST, FLORIDA ID APHASIA; ACTIVATION; BUFFER; SPEECH; ACCESS AB A theory-driven treatment was designed to facilitate access to the impaired output lexicons of a 47-year-old woman with aphasia resulting from a left parietal haemorrhage. In the context of a multiple-baseline design, lists of rhymed word pairs from four semantic categories were trained using a systematic cueing hierarchy. Performance measures were based on the subject's generation of targeted words, verbally and in writing, when presented with a rhyme of the target. Results demonstrated positive acquisition, generalization and maintenance effects for treated and untreated items across semantic categories. Delayed generalization patterns may be explained by retrieval inhibition (Blaxton and Bookheimer 1993) or lateral inhibition (McClelland and Rumelhart 1981). C1 VA Pittsburgh Healthcare Syst, Aphasia Rehabil Res Lab & Clin, Pittsburgh, PA USA. Univ Pittsburgh, Dept Commun Sci & Disorders, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. Univ Utah, Salt Lake City, UT USA. Vet Affairs Med Ctr, Salt Lake City, UT 84148 USA. RP Spencer, KA (reprint author), Univ Washington, Dept Speech & Hearing Sci, 1417 NE 42nd St, Seattle, WA 98105 USA. NR 43 TC 17 Z9 17 U1 6 U2 8 PU PSYCHOLOGY PRESS PI HOVE PA 27 CHURCH RD, HOVE BN3 2FA, EAST SUSSEX, ENGLAND SN 0268-7038 J9 APHASIOLOGY JI Aphasiology PD MAY-JUN PY 2000 VL 14 IS 5-6 BP 567 EP 584 PG 18 WC Clinical Neurology SC Neurosciences & Neurology GA 316ME UT WOS:000087170400011 ER PT J AU Boninger, ML Baldwin, M Cooper, RA Koontz, A Chan, L AF Boninger, ML Baldwin, M Cooper, RA Koontz, A Chan, L TI Manual wheelchair pushrim biomechanics and axle position SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE wheelchair user; biomechanics; rehabilitation ID SEAT POSITION; PROPULSION; FORCES; KINETICS AB Objective: The biomechanics of wheelchair propulsion have been linked to upper extremity injury. Specifically, prior studies have correlated increased median nerve dysfunction with increasing propulsion frequency and a higher rate of rise of the resultant, or total, pushrim force. Despite this link, there is little research on the effect of wheelchair setup on propulsion biomechanics. The objective of this study was to determine the effect of rear axle position relative to the shoulder on pushrim biomechanics, Design: Case series. Setting: Biomechanics laboratory. Participants: Forty individuals with paraplegia who use manual wheelchairs for mobility. Intervention: Subjects propelled their own wheelchairs on a dynamometer at two different steady-state speeds and going from a dead stop to maximum speed, Bilateral biomechanical data were obtained using a force- and moment-sensing pushrim and a motion analysis system. Main Outcome Measures: Position of the axle relative to the shoulder at rest both horizontal (XPOS) and vertical (YPOS), and pushrim biomechanical variables including frequency of propulsion, peak and rate of rise of the resultant force, planar moment, and push angle. Partial correlation coefficients between relative axle position and propulsion biomechanics variables were calculated. Results: After controlling for subject characteristics, XPOS was significantly correlated with the frequency of propulsion (p <.01) and the rate of rise of the resultant force (p <.05). In addition, both XPOS and YPOS were significantly correlated with the push angle at multiple speeds (p <.05). Conclusion: Specific biomechanical parameters known to correlate with median nerve injuries were found to be related to axle position relative to the shoulder. Providing wheelchair users with adjustable axle position and then Fitting the user to the wheelchair can improve propulsion biomechanics and likely reduce the risk of injury. C1 Univ Pittsburgh, Div Phys Med & Rehabil, Dept Orthopaed Surg, Pittsburgh, PA 15213 USA. VA Pittsburgh Healthcare Syst, Human Engn Res Labs, Pittsburgh, PA USA. Univ Pittsburgh, Dept Rehabil Sci & Technol, Pittsburgh, PA USA. Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. US Hlth Care Financing Adm, Div Clin Stand & Qual, Seattle, WA USA. RP Boninger, ML (reprint author), Univ Pittsburgh, Div Phys Med & Rehabil, Dept Orthopaed Surg, Suite 901 Kaufmann Bldg,3471 5th Ave, Pittsburgh, PA 15213 USA. RI Moro, Juan Carlos/A-4315-2015 OI Moro, Juan Carlos/0000-0002-4886-2967; Boninger, Michael/0000-0001-6966-919X FU NICHD NIH HHS [5 P01 HD33989 03, K08 HD01122-01] NR 17 TC 103 Z9 104 U1 2 U2 10 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD MAY PY 2000 VL 81 IS 5 BP 608 EP 613 DI 10.1053/mr.2000.1455 PG 6 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 311CT UT WOS:000086867800012 PM 10807100 ER PT J AU Yang, CC Stiens, SA AF Yang, CC Stiens, SA TI Antegrade continence enema for the treatment of neurogenic constipation and fecal incontinence after spinal cord injury SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE constipation; colon; neurogenic bowel; spinal cord injury; antegrade continence enema; rehabilitation ID COLONIC ENEMA; CHILDREN AB Objective: To describe the effects of an antegrade continence enema stoma formed in a paraplegic man with intractable constipation and fecal incontinence. Design: Case report. Setting: Spinal cord injury unit, Veterans Affairs hospital. Participants: Spinal cord injury (SCI) patient with T12 paraplegia. Intervention: Surgical formation of antegrade continence enema stoma. Main Outcome Measures: Time of bowel program care, ease of fecal elimination, safety of procedure. Results: Bowel care time was decreased from 2 hours to 50 minutes daily; 6 bowel medications were discontinued; fecal incontinence was eliminated; and no surgical or medical side effects noted after the procedure. Conclusion: The antegrade continence enema procedure is a safe and effective means of treating intractable constipation and fecal incontinence in the adult SCI patient. This option should be considered for those persons in whom medical management of bowel care has been unsuccessful. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, Urol Sect 112U, Seattle, WA 98108 USA. Univ Washington, Dept Urol, Seattle, WA 98195 USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. RP Yang, CC (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Seattle Div, Urol Sect 112U, Seattle, WA 98108 USA. NR 13 TC 9 Z9 11 U1 0 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD MAY PY 2000 VL 81 IS 5 BP 683 EP 685 DI 10.1053/mr.2000.3869 PG 3 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 311CT UT WOS:000086867800023 PM 10807111 ER PT J AU Clark, WR Shinaberger, JH AF Clark, WR Shinaberger, JH TI Clinical evaluation of a new high efficiency hemodialyzer: Polysynthane (TM) SO ASAIO JOURNAL LA English DT Article ID NATIONAL COOPERATIVE DIALYSIS; MASS-TRANSFER; HEMATOCRIT; MORBIDITY; SURVIVAL; KT/V AB Two increasingly common characteristics of the American chronic hemodialysis (HD) population, high hematocrit and large body size, may vender the currently recommended adequacy targets difficult to achieve, even with very efficient dialyzers. In a group of patients with these characteristics, we assessed the ability of a new high efficiency dialyzer (PSN(TM)210; Baxter Healthcare Corporation) to achieve the currently recommended adequacy targets. Six patients (mean pre-HD weight and hematocrit, 90.3 +/- 18.0 kg and 0.40 +/- 0.03 kg, respectively) were evaluated. At prescribed blood and dialysate flow rates of 400 and 800 ml/min, respectively, and a mean treatment duration of 4 hrs, mean delivered urea Kt/V and reduction ratio (URR) were 1.38 +/- 0.25 and 0.73 +/- 0.07, respectively. For the same flow rates, whole blood clearances for urea, creatinine, and phosphate were 315 +/- 13, 246 +/- 28, and 260 +/- 27 ml/min, respectively. These data indicate this dialyzer has an efficient mass transfer design allowing adequate dialysis to be delivered even to very large patients under high efficiency conditions. C1 Baxter Healthcare Corp, Div Renal, Mcgaw Pk, IL USA. Indiana Univ, Sch Med, Div Nephrol, Indianapolis, IN USA. W Los Angeles Dept Vet Affairs Med Ctr, Dialysis Unit, Los Angeles, CA USA. RP Clark, WR (reprint author), Wishard Mem Hosp, Baxter Healthcare Corp, Hemodialysis Res Lab, Myers Bldg,Room D711, Indianapolis, IN 46202 USA. NR 30 TC 17 Z9 18 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1058-2916 J9 ASAIO J JI Asaio J. PD MAY-JUN PY 2000 VL 46 IS 3 BP 288 EP 292 DI 10.1097/00002480-200005000-00009 PG 5 WC Engineering, Biomedical; Transplantation SC Engineering; Transplantation GA 346RF UT WOS:000088884300009 PM 10826738 ER PT J AU Glue, P Schenker, S Gupta, S Clement, RP Zambas, D Salfi, M AF Glue, P Schenker, S Gupta, S Clement, RP Zambas, D Salfi, M TI The single dose pharmacokinetics of ribavirin in subjects with chronic liver disease SO BRITISH JOURNAL OF CLINICAL PHARMACOLOGY LA English DT Article DE liver disease; pharmacokinetics; ribavirin ID CHRONIC HEPATITIS-C; PLACEBO-CONTROLLED TRIAL; DOUBLE-BLIND; INTERFERON-ALPHA-2B; COMBINATION; VOLUNTEERS; VIRUS AB Aims The primary objective of this study was to describe the single dose pharmacokinetics of ribavirin in subjects with normal liver function and those with various degrees of stable chronic liver disease. Additionally this study assessed the safety and tolerability of ribavirin in this population. Methods Single oral 600 mg doses of ribavirin were administered to healthy male and female volunteers (n=6) and patients with stable chronic Liver disease (n=17), in a parallel group study. Pharmacokinetic sampling and tolerability assessments were performed up to 168 h post dose. Results Single oral doses of 600 mg ribavirin were well tolerated by healthy volunteers and patients with varying degrees of hepatic dysfunction. Although mean C-max increased with the severity of hepatic dysfunction, there was no change in extent of absorption or renal clearance of ribavirin. Conclusions There are no pharmacokinetic reasons for initial dose adjustment of ribavirin in patients with hepatic dysfunction. C1 Schering Plough Res Inst, Kenilworth, NJ 07033 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Glue, P (reprint author), Schering Plough Res Inst, 2015 Galloping Hill Rd, Kenilworth, NJ 07033 USA. OI Glue, Paul/0000-0002-7305-2800 NR 20 TC 28 Z9 29 U1 0 U2 3 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND SN 0306-5251 J9 BRIT J CLIN PHARMACO JI Br. J. Clin. Pharmacol. PD MAY PY 2000 VL 49 IS 5 BP 417 EP 421 DI 10.1046/j.1365-2125.2000.00186.x PG 5 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 312EM UT WOS:000086930300003 PM 10792198 ER PT J AU Adams, SG Melo, J Luther, M Anzueto, A AF Adams, SG Melo, J Luther, M Anzueto, A TI Antibiotics are associated with lower relapse rates in outpatients with acute exacerbations of COPD SO CHEST LA English DT Article DE acute exacerbation of chronic bronchitis; antibiotics; bronchitis; COPD; pulmonary function; recurrence; relapse ID OBSTRUCTIVE PULMONARY-DISEASE; 30-CENTER NATIONAL SURVEILLANCE; RESPIRATORY-TRACT INFECTIONS; PROTECTED SPECIMEN BRUSH; CHRONIC-BRONCHITIS; ANTIMICROBIAL RESISTANCE; HAEMOPHILUS-INFLUENZAE; UNITED-STATES; STREPTOCOCCUS-PNEUMONIAE; BACTERIAL-COLONIZATION AB Background: COPD is a complex disease with exacerbations characterized by worsening of symptoms resulting in deteriorating lung function. Study objective: To assess predictive factors of relapse for patients with acute exacerbations of COPD (AECB). Design: Retrospective cohort analysis of visits for AECB, Setting: Veterans Affairs Medical Center. Patients: Three hundred sixty-two visits (173 patients) with documented COPD treated as outpatients for AECB. Measurements: Severity of underlying COPD, severity of AECB, comorbid conditions, therapy, and relapse rates (return visit within 14 days with persistent or worsening symptoms). Results: Each. visit was analyzed individually (referred to as a patient-visit). One group received antibiotics (270 patient-visits), and the second group (92 patient-visits) did not. Both groups had similar demographics and severity of underlying COPD, The overall relapse rate was 22%. The majority of patient-visits (95%) with severe symptoms at presentation were prescribed antibiotics vs only 40% of those with mild symptoms, Twenty-nine of 92 patient-visits (32%) were followed by relapse in the group that was not given antibiotics, whereas only 50 of 270 (19%) treated with antibiotics relapsed (p < 0.001), Those treated with amoxicillin had an even higher relapse rate (20 of 37 patient-visits, or 54%) than those who did not receive antibiotics (p = 0.006). Conclusions: Relapse from AECB was not related to the severity of underlying disease or to the severity of the acute exacerbation. Patients treated with antibiotics had significantly lower relapse rates than those who did not receive antibiotics. However, the specific choice of antibiotic is important because those treated with amoxicillin had the highest relapse rates of all groups. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Pulm Dis Crit Care Med, San Antonio, TX 78284 USA. Audie L Murphy Mem Vet Hosp Div, S Texas Vet Hlth Care Syst, San Antonio, TX 78284 USA. Clin Medellin, Medellin, Colombia. RP Anzueto, A (reprint author), Audie L Murphy Mem Vet Hosp, Pulm Dis Sect 111E, 7400 Merton Minter Blvd, San Antonio, TX 78284 USA. NR 49 TC 122 Z9 126 U1 0 U2 1 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD MAY PY 2000 VL 117 IS 5 BP 1345 EP 1352 DI 10.1378/chest.117.5.1345 PG 8 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 315DL UT WOS:000087097300023 PM 10807821 ER PT J AU Steele, BG Holt, L Belza, B Ferris, S Lakshminaryan, S Buchner, DM AF Steele, BG Holt, L Belza, B Ferris, S Lakshminaryan, S Buchner, DM TI Quantitating physical activity in COPD using a triaxial accelerometer SO CHEST LA English DT Article DE ambulatory monitoring; chronic limitation of activity; COPD; exercise ID OBSTRUCTIVE PULMONARY-DISEASE; ENERGY-EXPENDITURE; OBESE CHILDREN; SELF-REPORT; REHABILITATION; RELIABILITY; STABILITY; ACCURACY; EXERCISE; VALIDITY AB Study Objective: To determine the reliability, validity, and stability of a triaxial accelerometer for walking and daily activity measurement in a COPD sample. Design: Cross-sectional, correlational, descriptive design, Setting: Outpatient pulmonary rehabilitation program in a university-affiliated Veterans Affairs medical center. Participants: Forty-seven outpatients (44 men and 3 women) with stable COPD (FEV1, 37% predicted; SD, 16%) prior to entry into a pulmonary rehabilitation program, Measurements and results: Test-retest reliability of a triaxial movement sensor (Tritrac R3D Research Ergometer; Professional Products; Madison, WI) was evaluated in 35 of the 47 subjects during three standardized 6-min walks (intraclass correlation coefficient [rICC] = 0.84). Pearson correlations evaluated accelerometer concurrent validity as a measure of walking (in vector magnitude units), compared to walking distance in all 47 subjects during three sequential 6-min walks (0.84, 0.85, and 0.95, respectively; p < 0.001). The validity of the accelerometer as a measure of daily activity over 3 full days at home was evaluated in all subjects using Pearson correlations with other indicators of functional capacity. The accelerometer correlated with exercise capacity (maximal G-min walk, r = 0.74; p < 0.001); level of obstructive disease (FEV1 percent predicted, r = 0.62; p < 0.001); dyspnea (Functional Status and Dyspnea Questionnaire, dyspnea over the past 30 days, r = - 0.29; p < 0.05); and activity self-efficacy (Activity Self-Efficacy Questionnaire, r = 0.43; p < 0.01); but not with self-report of daily activity (Modified Activity Recall Questionnaire, r = 0.14; not significant). Stability of the accelerometer to measure 3 full days of activity at home was determined by an rICC of 0.69, Conclusions: This study provides preliminary data suggesting that a triaxial movement sensor is a reliable, valid, and stable measure of walking and daily physical activity in COPD patients, It has the potential to provide more precise measurement of everyday physical functioning in this population than self-report measures currently in use, and measures an important dimension of functional status not previously well-described. C1 Vet Affairs Puget Sound Hlth Care Syst, Med Specialties & Primary Care Serv 111B, Seattle, WA 98108 USA. Univ Washington, Sch Nursing, Dept Biobehav Nursing & Hlth, Seattle, WA 98195 USA. Univ Washington, Sch Med, Seattle, WA 98195 USA. Good Samaritan Med Ctr, Puyallup, WA USA. Ctr Dis Control & Prevent, Phys Act & Hlth Branch, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. RP Steele, BG (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Med Specialties & Primary Care Serv 111B, 1660 Columbian Way S, Seattle, WA 98108 USA. RI Schmoelz, Camilie/D-1707-2012 OI Schmoelz, Camilie/0000-0003-2221-9954 NR 29 TC 131 Z9 134 U1 2 U2 9 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD MAY PY 2000 VL 117 IS 5 BP 1359 EP 1367 DI 10.1378/chest.117.5.1359 PG 9 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 315DL UT WOS:000087097300025 PM 10807823 ER PT J AU Keith, RL Miller, YE Germmill, RM Drabkin, HA Dempsey, EC Kennedy, TC Prindiville, S Franklin, WA AF Keith, RL Miller, YE Germmill, RM Drabkin, HA Dempsey, EC Kennedy, TC Prindiville, S Franklin, WA TI Angiogenic squamous dysplasia in bronchi of individuals at high risk for lung cancer SO CLINICAL CANCER RESEARCH LA English DT Article ID X-C CHEMOKINES; CELL-PROLIFERATION; FORMER SMOKERS; LESIONS; P53; CARCINOMA; TUMORS; KI-67; FLUORESCENCE; EPITHELIUM AB Lung carcinogenesis is assumed to be a multistep process, but detailed understanding of the sequential morphological and molecular changes preceding invasive lung cancer remains elusive. To better understand early lung carcinogenesis, we initiated a program of fluorescence bronchoscopy in smokers at high risk for lung cancer. in the bronchial biopsies from these subjects, we observed a unique lesion consisting of capillary blood vessels closely juxtaposed to and projecting into metaplastic or dysplastic squamous bronchial epithelium, angiogenic squamous dysplasia (ASD). Serial sections of the capillary projections confirmed that they represent intramucosal capillary loops. Microvessel density in ASD was elevated in comparison to normal mucosa (P = 0.0003) but not in comparison to other forms of hyperplasia or dysplasia, ASD thus represents a qualitatively distinct form of angiogenesis in which there is architectural rearrangement of the capillary microvasculature. Genetic analysis of surface epithelium in a random subset of lesions revealed toss of heterozygosity at chromosome 3p in 53% of ASD lesions. No confirmed p53 mutations were identified, Compared with normal epithelium, proliferative activity was markedly elevated in ASD lesions. ASD occurred in 54 of 158 (34%) high-risk smokers without carcinoma and in 6 of 10 patients with squamous carcinoma who underwent fluorescence bronchoscopy, One early-stage invasive carcinoma was noteworthy fur the occurrence of ASD juxtaposed to invasive tumor. Seventy-seven (59%) of the ASD lesions mere detected by abnormal fluorescence alone. Twenty: bronchial sites (11 patients) were rebiopsied I year after the initial diagnosis. At nine (45%) of these sites, the lesion was found to persist. The Lesion was not present in biopsies from 16 normal nonsmoker control subjects. The presence of this lesion in high-risk smokers suggests that aberrant patterns of microvascularization mag occur at an early stage of bronchial carcinogenesis. C1 Univ Colorado, Hlth Sci Ctr, SPORE Lung Canc, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Dept Pulm Sci & Crit Care Med, Denver, CO 80220 USA. RP Franklin, WA (reprint author), Univ Colorado, Hlth Sci Ctr, SPORE Lung Canc, Box B-216,4200 E 9th Ave, Denver, CO 80262 USA. FU NCI NIH HHS [U01-CA85070, CA 58187] NR 47 TC 114 Z9 128 U1 0 U2 1 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD MAY PY 2000 VL 6 IS 5 BP 1616 EP 1625 PG 10 WC Oncology SC Oncology GA 312LY UT WOS:000086945800004 PM 10815878 ER PT J AU Virella, G Koskinen, S Krings, G Onorato, JM Thorpe, SR Lopes-Virella, M AF Virella, G Koskinen, S Krings, G Onorato, JM Thorpe, SR Lopes-Virella, M TI Immunochemical characterization of purified human oxidized low-density lipoprotein antibodies SO CLINICAL IMMUNOLOGY LA English DT Article DE arteriosclerosis; autoimmunity; autoantibodies; cardiolipin; crossreactivity; diabetes; oxidized LDL; oxLDL antibodies ID CONTAINING IMMUNE-COMPLEXES; CORONARY-ARTERY DISEASE; OXIDATIVE MODIFICATION; ANTICARDIOLIPIN ANTIBODIES; MONOCLONAL-ANTIBODIES; ANTIPHOSPHOLIPID ANTIBODIES; CAROTID ATHEROSCLEROSIS; MYOCARDIAL-INFARCTION; LIPID-PEROXIDATION; HUMAN MACROPHAGES AB The goal of this study was to characterize the isotypes and reactivity of human autoantibodies to copper oxidized LDL (oxLDL). Forty-six purified oxLDL antibodies contained immunoglobulins of the three major isotypes, with a predominance of IgG;, subclasses 1 and 3. These IgG isotypes are known to interact with FcR gamma I and to activate the complement system and thus are potentially able to activate macrophages and cause foam cell formation. The same purified antibodies were tested for cross-reactivity with malondialdehyde (MDA)-, glycated (Glyc)-, and native (n)LDL and cardiolipin. Absorption with oxLDL resulted in a decrease of reactivity of 77.2 +/- 4.7%. Absorption with MDA-LDL resulted in a wider range of reduction of reactivity values, ranging from 50 to 87%, possibly reflecting differences in the degree of MDA modification. Absorption with Glyc- and nLDL caused a minor decrease in the reactivity of antibodies to oxLDL (5.9 +/- 7.1 and 6.8 +/- 6.4%, respectively), comparable to the reduction of reactivity (2.1 +/- 4.0%) measured after absorption with transferrin, an irrelevant protein used as a negative control. These results suggest that oxLDL antibodies recognize primarily MDA epitopes. To determine whether purified oxLDL antibodies also recognize other epitopes known to be generated during copper oxidation of LDL, such as 4-hydroxynonenal (HNE- and N''(carboxymethyl)-lysine (CML), two additional sets of experiments were carried out. First, we monitored the formation of CML-, MDA-lysine, and HNE-lysine at different times during copper oxidation of two LDL pools. Both pools showed simultaneous increases in protein modification, as indicated by increasing fluorescence emission at 430 nm, and in immunoreactivity with oxLDL antibodies, coinciding closely with MDA modification of lysine groups. Second, we assessed whether the reactivity of oxLDL antibodies could be blocked by absorption with CML- or HNE-LDL. HNE-LDL did not react with isolated oxLDL antibodies. Highly modified CML-LDL (>90% of lysine residues modified) reduced the reactivity of oxLDL antibodies, but only by 25.5%. Finally, we investigated the possible cross-reactivity of oxLDL antibodies with cardiolipin. Seventeen purified oxLDL antibodies were used in this study, which showed that absorption with oxLDL or nLDL did not affect their reactivity with immobilized cardiolipin, (C) 2000 Academic Press. C1 Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. Med Univ S Carolina, Ralph H Johnson VA Med Ctr, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Med, Div Endocrinol Diabet & Med Genet, Charleston, SC 29425 USA. Univ S Carolina, Dept Chem & Biochem, Columbia, SC USA. RP Virella, G (reprint author), Med Univ S Carolina, Dept Microbiol & Immunol, Charleston, SC 29425 USA. FU NHLBI NIH HHS [HL-55782]; NIDDK NIH HHS [DK19971] NR 52 TC 43 Z9 47 U1 0 U2 0 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1521-6616 J9 CLIN IMMUNOL JI Clin. Immunol. PD MAY PY 2000 VL 95 IS 2 BP 135 EP 144 DI 10.1006/clim.2000.4857 PG 10 WC Immunology SC Immunology GA 311HA UT WOS:000086877600008 PM 10779407 ER PT J AU Rosenfeld, K Wenger, NS AF Rosenfeld, K Wenger, NS TI Measuring quality in end-of-life care SO CLINICS IN GERIATRIC MEDICINE LA English DT Article ID CANCER PAIN MANAGEMENT; ADVANCE DIRECTIVES; TERMINALLY ILL; TREATMENT CHOICES; LUNG-CANCER; HEALTH; OLDER; QUESTIONNAIRE; RESUSCITATION; DECISIONS AB Scrutiny of the quality of medical care near the end of Life is increasing. Experts have begun to define and conceptualize quality of care for dying patients and are developing measurement tools to assess quality of care in this population. Definitions and conceptual models of quality of care at the end of life are reviewed. Approaches for measuring the processes and outcomes of end-of-life care are discussed. Approaches for initiating quality assessment of end-of-life care among geriatric patients are suggested. C1 VA Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Los Angeles, CA 90012 USA. RP Rosenfeld, K (reprint author), VA Greater Los Angeles Healthcare Syst, Dept Gen Med 111G, 11301 Wilshire Blvd, Los Angeles, CA 90012 USA. NR 61 TC 18 Z9 18 U1 3 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0749-0690 J9 CLIN GERIATR MED JI Clin. Geriatr. Med. PD MAY PY 2000 VL 16 IS 2 BP 387 EP + DI 10.1016/S0749-0690(05)70063-X PG 16 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 312VJ UT WOS:000086964400012 PM 10783435 ER PT J AU Schumacher, HR AF Schumacher, HR TI Gout and other crystal-associated arthritis SO CURRENT OPINION IN RHEUMATOLOGY LA English DT Editorial Material C1 Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. RP Schumacher, HR (reprint author), Vet Affairs Med Ctr, 151K,Univ & Woodland Ave, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1040-8711 J9 CURR OPIN RHEUMATOL JI CURR. OPIN. RHEUMATOL. PD MAY PY 2000 VL 12 IS 3 BP 211 EP 212 DI 10.1097/00002281-200005000-00009 PG 2 WC Rheumatology SC Rheumatology GA 307BN UT WOS:000086633700009 ER PT J AU Sepulveda, AR Wu, L Ota, H Gutierrrez, O Kim, JG Genta, RM Graham, DY AF Sepulveda, AR Wu, L Ota, H Gutierrrez, O Kim, JG Genta, RM Graham, DY TI Molecular identification of main cellular lineages as a tool for the classification of gastric cancer SO HUMAN PATHOLOGY LA English DT Article DE gastric; carcinoma; molecular; classification; microsatellite; instability; phenotype ID INSTABILITY-ASSOCIATED MUTATIONS; HIGH-RISK POPULATION; MICROSATELLITE INSTABILITY; HELICOBACTER-PYLORI; INTESTINAL-TYPE; ORGANOID DIFFERENTIATION; MUCOUS CELLS; SIALOSYL-TN; CARCINOMA; EXPRESSION AB Gastric carcinomas (GC) are heterogeneous tumors comprising variable amounts of cells of different lineage phenotype, including gastric mucous cells (surface-SMC or gland-GMC) and intestinal cells (IC). The evaluation of tumor behavior has classically depended on strictly morphological classifications of tumors. Microsatellite instability (MSI) is frequently detected in GC, but whether MSI affects all gastric cellular lineages or exclusively occurs in unique cellular lineages in GC is not known. The aims of this study were to test a combination of anti-mucin antibodies to classify gastric cancer into predominant cell lineage phenotype and to determine whether MSI in GC is associated with particular cellular tumor phenotypes. Fifty-five GC were immunophenotyped with antibodies specific for SMC, GMC, or IC. DNA was extracted from tumor and non-neoplastic gastric tissues and amplified with 5 microsatellite markers. A mixed cellular pattern was the most frequent phenotype of GC (61%) and was seen in both glandular (63%) and diffuse (58%)-type tumors. No significant difference in the rate of MSI was found in tumors with predominant gastric, intestinal or mixed phenotype. However, tumors with null or low-level expression of cellular lineage differentiation markers displayed MSI more frequently than tumors with high-level expression (40% v 20%). In conclusion, different gastric carcinoma cell lineage patterns can be easily identified with the 3 immunohistochemical markers used in this study. The 3 main cellular lineage components of gastric cancer can be similarly affected by microsatellite instability, consistent with the notion that MSI is an early event in gastric carcinogenesis. Copyright (C) 2000 by W.B. Saunders Company. C1 Vet Affairs Med Ctr 111D, Dept Med, Houston, TX 77030 USA. Vet Affairs Med Ctr 111D, Dept Pathol, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Korea Univ, Guro Hosp, Coll Med, Seoul 136701, South Korea. Univ Nacl Colombia, Bogota, Colombia. RP Sepulveda, AR (reprint author), Vet Affairs Med Ctr 111D, Dept Med, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 45 TC 15 Z9 15 U1 0 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0046-8177 EI 1532-8392 J9 HUM PATHOL JI Hum. Pathol. PD MAY PY 2000 VL 31 IS 5 BP 566 EP 574 DI 10.1053/hp.2000.6684 PG 9 WC Pathology SC Pathology GA 313TE UT WOS:000087014700006 PM 10836295 ER PT J AU Patel, NJ Bush, RK AF Patel, NJ Bush, RK TI Role of environmental allergens in rhinitis SO IMMUNOLOGY AND ALLERGY CLINICS OF NORTH AMERICA LA English DT Article ID HOUSE DUST MITES; FEL-D-I; LABORATORY-ANIMAL ALLERGY; CAT-ALLERGEN; ASPERGILLUS-FUMIGATUS; ALTERNARIA-ALTERNATA; MOLECULAR-CLONING; POLLEN ALLERGENS; INDOOR ALLERGENS; MAJOR ALLERGEN AB This article reviews the various important aspects of commonly implicated environmental allergens in allergic rhinitis. As evident by the high prevalence of allergic rhinitis in the general population, environmental allergens are among the most common causes of rhinitis. Environmental allergens may be categorized into those that are found in the outdoor environment and those that are found in the indoor environment. Pollens and fungi are the two primary allergen sources in the outdoor environment and most often provoke seasonal symptoms (especially in temperate climates). important indoor allergens include animals, dust mites, and fungi, which are usually present perennially, and commonly produce chronic symptoms. Environmental control measures should be considered in the treatment of allergic rhinitis; however, given the enormous distribution of many allergens, they are often difficult to carry out. C1 William S Middleton Mem Vet Hosp, Dept Allergy & Immunol, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Allergy & Immunol Sect, Madison, WI USA. RP Bush, RK (reprint author), William S Middleton Mem Vet Hosp, Dept Allergy & Immunol, 2500 Overlook Terrace, Madison, WI 53705 USA. NR 81 TC 6 Z9 6 U1 1 U2 4 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0889-8561 J9 IMMUNOL ALLERGY CLIN JI Immunol. Allerg. Clin. North Am. PD MAY PY 2000 VL 20 IS 2 BP 323 EP + DI 10.1016/S0889-8561(05)70151-X PG 32 WC Allergy; Immunology SC Allergy; Immunology GA 319WD UT WOS:000087365600006 ER PT J AU Bonanno, E Iurlaro, M Madri, JA Nicosia, RF AF Bonanno, E Iurlaro, M Madri, JA Nicosia, RF TI Type IV collagen modulates angiogenesis and neovessel survival in the rat aorta model SO IN VITRO CELLULAR & DEVELOPMENTAL BIOLOGY-ANIMAL LA English DT Article DE endothelium; basement membrane; elongation; proliferation; stabilization ID ENDOTHELIAL GROWTH-FACTOR; BASEMENT-MEMBRANE; EXTRACELLULAR-MATRIX; CELL PROLIFERATION; IN-VITRO; INVITRO; LAMININ; METALLOPROTEINASES; DIFFERENTIATION; MICROVESSELS AB Type IV collagen is a major basement membrane component that has been implicated in the regulation of angiogenesis. The purpose of this study was to evaluate the effect of type IV collagen an the angiogenic response of native endothelial cells in three-dimensional vascular organ culture. Rings of rat aorta were cultured under serum-free conditions in gels of type I collagen with or without type IV collagen. In the absence of type IV collagen, aortic rings generated neovessels, which proliferated until day 9 and gradually regressed during the second and third weeks of culture. Type IV collagen promoted neovessel elongation and survival in a dose-dependent manner. Microvascular length increased by 43, 57, and 119% over control values in cultures treated with 3, 30, and 300 mu g/ml type IV collagen, respectively. When used at high concentrations (300 mu g/ml) type TV collagen stabilized the neovascular outgrowths and prevented vascular regression. Type IV collagen also promoted the formation of neovessels, but significant stimulatory effects were observed only at an intermediate concentration (30 mu g/ml) and were no longer significant at the high concentration (300 mu g/ml). The observation that type IV collagen has dose-dependent effects on vascular elongation, proliferation, and stabilization, supports the concept that the developing basement membrane of neovessels acts as a solid-phase regulator of angiogenesis, whose function varies depending on the concentration of its molecular components. C1 VA Puget Sound Hlth Care Syst, Div Pathol & Lab Med, Lab S 113, Diagnost Serv, Seattle, WA 98108 USA. Univ Roma Tor Vergata, Dept Surg, Rome, Italy. Univ Bari, Dept Biomed Sci & Human Oncol, Bari, Italy. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. Yale Univ, Sch Med, Dept Pathol, New Haven, CT 06510 USA. RP Nicosia, RF (reprint author), VA Puget Sound Hlth Care Syst, Div Pathol & Lab Med, Lab S 113, Diagnost Serv, 1660 S Columbian Way, Seattle, WA 98108 USA. OI bonanno, elena/0000-0002-0222-0141 FU NHLBI NIH HHS [HL52585] NR 35 TC 42 Z9 43 U1 0 U2 0 PU SOC IN VITRO BIOLOGY PI LARGO PA 9315 LARGO DR WEST, STE 25, LARGO, MD 20774 USA SN 1071-2690 J9 IN VITRO CELL DEV-AN JI In Vitro Cell. Dev. Biol.-Anim. PD MAY PY 2000 VL 36 IS 5 BP 336 EP 340 PG 5 WC Cell Biology; Developmental Biology SC Cell Biology; Developmental Biology GA 341NP UT WOS:000088596700011 PM 10937837 ER PT J AU Egan, CL Liu, V Harris, RM White, SM Lessin, SR Weinberg, JM AF Egan, CL Liu, V Harris, RM White, SM Lessin, SR Weinberg, JM TI Linear IgA disease associated with membranous glomerulonephropathy SO INTERNATIONAL JOURNAL OF DERMATOLOGY LA English DT Article ID TARGET ANTIGENS; BULLOUS DERMATOSIS AB A 33-year-old Caucasian man developed an acute nephrotic syndrome with a proteinuria of 15 g/day. His past medical history was significant for a cholecystectomy secondary to complications of hypercholesterolemia, and his medications included niacinamide, simvastatin, and multivitamins. A renal biopsy revealed a membranous glomerulonephropathy, with thickening of the capillary loops by light microscopy and 4+ granular immunoglobulin G (IgG) staining of the capillary loops by immunofluorescence. Multiple discrete subepithelial deposits were also noted by electron microscopy. He was treated with cyclophosphamide, chlorambucil, and high dose steroids. Laboratory data at that time were notable for an elevated erythrocyte sedimentation rate (ESR), decreased albumin, a negative antinuclear antibody, and normal complement levels. His symptoms improved, and the proteinuria stabilized to 7 g/day. His systemic therapy was discontinued without a flare in his renal disease. Approximately 9 months later, he developed a pruritic, blistering eruption which began on his face and neck. An initial skin biopsy showed a subepidermal blister with many eosinophils and eosinophilic spongiosis. A direct immunofluorescence (DIF) study revealed linear deposits of IgG and IgA, and focally linear C3 at the basement membrane zone. This pattern was interpreted to be most consistent with bullous pemphigoid. He was referred to the Philadelphia VA Medical Center for further evaluation and treatment. Cutaneous examination revealed multiple urticarial plaques with tense bullae studding the peripheral margin, in a rosette pattern, distributed on his face, trunk, groin, extremities, and feet, with one healing erosion on the hard palate. Laboratory data revealed abnormal, but stable, renal disease, with an elevated blood urea nitrogen (21.1) and creatinine (1.5). Serum IgA was elevated (400), and serum albumin (3.3) and a total protein (5.5) were decreased. A second skin biopsy from a blister edge demonstrated a subepidermal bulla with numerous eosinophils and collections of neutrophils at the dermal papillae tips (Fig. 1). DIF revealed 3+ linear IgA deposition at the basement membrane zone (Fig. 2), and an indirect immunofluorescence study on monkey esophagus showed linear IgA deposition in the basement membrane zone. A diagnosis of linear IgA disease was made. Dapsone 50 mg p.o. daily was started, with a dramatic improvement on his blistering within 2 weeks. His renal disease remained stable. C1 New York Med Coll, Metropolitan Hosp Ctr, Dept Dermatol, New York, NY 10029 USA. Univ Penn, Sch Med, Dept Dermatol, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. RP Weinberg, JM (reprint author), New York Med Coll, Metropolitan Hosp Ctr, Dept Dermatol, 1901 1st Ave, New York, NY 10029 USA. NR 13 TC 3 Z9 3 U1 0 U2 0 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND SN 0011-9059 J9 INT J DERMATOL JI Int. J. Dermatol. PD MAY PY 2000 VL 39 IS 5 BP 379 EP 382 DI 10.1046/j.1365-4362.2000.00841-6.x PG 4 WC Dermatology SC Dermatology GA 319JY UT WOS:000087338800015 PM 10849404 ER PT J AU Perell, KL Gregor, RJ Scremin, AME AF Perell, KL Gregor, RJ Scremin, AME TI Bicycle pedal kinetics following force symmetry feedback training in subjects with unilateral cerebrovascular accident SO JOURNAL OF APPLIED BIOMECHANICS LA English DT Article DE cycling; hemiplegia; biomechanics; cerebral vascular disorders; asymmetry; feedback ID ELECTROMYOGRAPHIC FEEDBACK; BIOFEEDBACK; ERGOMETER; MECHANICS AB The purpose of this study was to compare individual pedal reaction force components following bicycle training with and without effective force feedback in subjects with unilateral cerebrovascular accident (CVA). Eight ambulatory subjects with CVA were studied on a recumbent bicycle equipped with custom-built pedals, which measure normal and tangential components of the load applied to the pedal surface. Comparisons of normal and tangential pedal reaction forces were made following 1 month of bicycle training (3 times/week for 3 weeks) during retention tests performed without feedback. The ratios of involved to contralateral (I/C ratios) force parameters were used to assess symmetry. Subjects were randomly assigned to 2 groups: (a) a feedback group that received visual/verbal. feedback regarding Effective force patterns, bilaterally, after each trial; and (b) a no-feedback group that received no feedback. Two critical results were found: (a) tangential pedal forces were significantly more posteriorly directed bilaterally following training across all subjects, but the change war; greater for the no-feedback group relative to the feedback group, and (b) effective force feedback training did net demonstrate improvements in the I/C ratios above that of the control group. A more posteriorly applied tangential pedal force may represent increased dorsiflexion and may suggest that bicycle training facilitated ankle control. The cyclical nature of cycling, however, may allow for natural patterns to develop without feedback or may require less frequent use of feedback based on retention test performance. C1 W LA Healthcare Ctr, VA Greater LA Healthcare Syst, Phys Med & Rehabil Serv, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, PM&R Div, Los Angeles, CA 90024 USA. Mt St Marys Coll, Dept Phys Therapy, Los Angeles, CA 90049 USA. Georgia Inst Technol, Dept Hlth & Performance Sci, Atlanta, GA 30332 USA. RP Perell, KL (reprint author), W LA Healthcare Ctr, VA Greater LA Healthcare Syst, Phys Med & Rehabil Serv, Los Angeles, CA 90073 USA. NR 22 TC 2 Z9 2 U1 1 U2 2 PU HUMAN KINETICS PUBL INC PI CHAMPAIGN PA 1607 N MARKET ST, PO BOX 5076, CHAMPAIGN, IL 61820-2200 USA SN 1065-8483 J9 J APPL BIOMECH JI J. Appl. Biomech. PD MAY PY 2000 VL 16 IS 2 BP 124 EP 141 PG 18 WC Engineering, Biomedical; Sport Sciences SC Engineering; Sport Sciences GA 316UM UT WOS:000087186500002 ER PT J AU Deem, S Berg, JT Kerr, ME Swenson, ER AF Deem, S Berg, JT Kerr, ME Swenson, ER TI Effects of the RBC membrane and increased perfusate viscosity on hypoxic pulmonary vasoconstriction SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE anemia; nitric oxide; hypoxia; red blood cells ID NITRIC-OXIDE GENERATION; ISOLATED RAT LUNGS; VASCULAR-RESISTANCE; METHYLENE-BLUE; RABBIT LUNGS; BLOOD; ENDOTHELIUM; HEMOGLOBIN; CELLS; SCAVENGE AB Red blood cells (RBCs) augment hypoxic pulmonary vasoconstriction (HPV) in part by scavenging of nitric oxide (NO) by Hb (Deem 8, Swenson ER, Alberts MK, Hedges RG, and Bishop MJ, Am J Respir Grit Care Med 157: 1181-1186, 1998). We studied the contribution of the RBC compartmentalization of Hb to augmentation of HPV and scavenging of NO in isolated perfused rabbit lungs. Lungs were initially perfused with buffer; HPV was provoked by a 5-min challenge with hypoxic gas (inspired O-2 fraction 0.05). Expired NO was measured continuously. Addition of free Hb to the perfusate (0.25 mg/ml) resulted in augmentation of HPV and a fall in expired NO that were similar in magnitude to those associated with a hematocrit of 30% (intracellular Hb of 100 mg/ml). Addition of dextran resulted in a blunting of HPV after free Hb but no change in expired NO. Blunting of HPV by dextran was not prevented by NO synthase inhibition with N-omega-nitro-L-arginine and/or cyclooxygenase inhibition. RBC ghosts had a mild inhibitory effect on HPV but caused a small reduction in expired NO. In conclusion, the RBC membrane provides a barrier to NO scavenging and augmentation of KPV by Hb. Increased perfusate viscosity inhibits HPV by an undetermined mechanism. C1 Univ Washington, Dept Anesthesiol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Deem, S (reprint author), Harborview Med Ctr, Dept Anesthesiol, Box 359724,325 9th Ave, Seattle, WA 98104 USA. FU NHLBI NIH HHS [HL03796, HL45571] NR 37 TC 14 Z9 14 U1 0 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD MAY PY 2000 VL 88 IS 5 BP 1520 EP 1528 PG 9 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 313DL UT WOS:000086985000003 PM 10797107 ER PT J AU Holgado, R Haire, H Ross, D Sprague, S Pahl, M Jara, A Martin-Malo, A Rodriguez, M Almaden, Y Felsenfeld, AJ AF Holgado, R Haire, H Ross, D Sprague, S Pahl, M Jara, A Martin-Malo, A Rodriguez, M Almaden, Y Felsenfeld, AJ TI Effect of a low calcium dialysate on parathyroid hormone secretion in diabetic patients on maintenance hemodialysis SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Article DE calcium; diabetes; hemodialysis; parathyroid hormone; renal osteodystrophy ID ADYNAMIC BONE-DISEASE; SET-POINT; SECONDARY HYPERPARATHYROIDISM; APLASTIC OSTEODYSTROPHY; PROXIMAL CALCIPHYLAXIS; RENAL OSTEODYSTROPHY; CAPD PATIENTS; PREDIALYSIS; ALUMINUM; PTH AB Diabetic patients on maintenance dialysis often are characterized by a relative parathyroid hormone (PTH) deficiency and a form of renal osteodystrophy with low bone turnover known as adynamic bone. The goal of the present study was to determine whether a reduction in the dialysate calcium concentration would increase the predialysis (basal) PTH and maximal PTH level. Thirty-three diabetic maintenance hemodialysis patients with basal PTH values less than 300 pg/ml were randomized to be dialyzed with either a regular (3.0 mEq/liter or 3.5 mEq/liter, group I) or low (2.25 mEq/liter or 2.5 mEq/liter, group II) calcium dialysate for 1 year. At baseline and after 6 months and 12 months of study, low (1 mEq/liter) and high (4 mEq/liter) calcium dialysis studies were performed to determine parathyroid function. At baseline, basal (I, 126 +/- 20 vs. II, 108 +/- 19 pg/ml) and maximal (I, 269 pg/ml +/- 40 pg/ml vs. II, 342 pg/ml +/- 65 pg/ml) PTH levels were not different. By 6 months, basal (I, 98 +/- 18 vs. II, 200 +/- 34 pg/ml, p = 0.02) and maximal (I, 276 pg/ml +/- 37 pg/ml vs. II, 529 pg/ml +/- 115 pg/ml; p = 0.05) PTH levels were greater in group II. Repeated measures analysis of variance (ANOVA) of the 20 patients who completed the entire 12-month study showed that only in group II patients were basal PTH (p = 0.01), maximal PTH (p = 0.01), and the basal/maximal PTH ratio (p = 0.03) different; by post hoc test, each was greater (p < 0.05) at 6 months and 12 months than at baseline. When study values at 0, 6, and 12 months in all patients were combined, an inverse correlation was present between basal calcium and both the basal/maximal PTH ratio (r = -0.59; p < 0.001) and the basal PTH (r = -0.60; p < 0.001). In conclusion, in diabetic hemodialysis patients with a relative PTH deficiency (1) the use of a low calcium dialysate increases basal and maximal PTH levels, (2) the increased secretory capacity (maximal PTH) during treatment with a low calcium dialysate suggests the possibility of enhanced parathyroid gland growth, and (3) the inverse correlation between basal calcium and both the basal/maximal PTH ratio and the basal PTH suggests that the steady-state PTH level is largely determined by the prevailing serum calcium concentration. C1 Hosp Univ Reina Sofia, Dept Nephrol, Cordoba, Spain. Dialysis Serv Florida, Ft Walton Beach, FL USA. St Francis Hosp, Wichita, KS USA. Univ Chicago, Chicago, IL 60637 USA. Univ Calif Irvine, Irvine, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Hosp Univ Reina Sofia, Unit Invest, Cordoba, Spain. W Los Angeles Vet Affairs Med Ctr, Nephrol Sect 111L, Dept Med, Los Angeles, CA 90073 USA. RP Felsenfeld, AJ (reprint author), W Los Angeles Vet Affairs Med Ctr, Nephrol Sect 111L, Dept Med, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. RI Rodriguez, teresa/H-5452-2011 NR 33 TC 23 Z9 23 U1 0 U2 1 PU AMER SOC BONE & MINERAL RES PI DURHAM PA PO BOX 2759, DURHAM, NC 27715-2759 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD MAY PY 2000 VL 15 IS 5 BP 927 EP 935 DI 10.1359/jbmr.2000.15.5.927 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 306PR UT WOS:000086605500016 PM 10804023 ER PT J AU Hanita, M AF Hanita, M TI Self-report measures of patient utility: should we trust them? SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE patient preference; expected utility; measurement; patient self-report; medical decision mailing; cognitive psychology ID DECISION-MAKING; CATEGORY ACCESSIBILITY; IMPRESSION-FORMATION; SOCIAL-PERCEPTION; POSITIVE AFFECT; JUDGMENT; INFORMATION; PREFERENCES; MEMORY; CHOICE AB As self-reports, measures of patient utility are susceptible to the effects of cognitive biases in patients. This article presents often overlooked problems in these measures by outlining cognitive processes involved in patient self-report. It is argued that these measures: 1) require overly complex mental operations: 2) fail to elicit thoughtful response by default; 3) may be biased by patients' mood; 4) are affected by both researchers' choice of measurement instruments and patients' choice of judgment strategies: 5) tend to reflect the disproportionate influence of patients' values that happen to be recallable at the time of measurement: and 6) are affected by patients' fear of regret. It is suggested that solutions for these problems should involve: a) improving the methods of administration; b) developing measures that are less taxing to patients; and c) redefining the concept of patient utility as judged. as opposed to retrieved. evaluation. Published by 2000 Elsevier Science Inc. All rights reserved. C1 Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP Hanita, M (reprint author), Houston Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 65 TC 19 Z9 21 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD MAY PY 2000 VL 53 IS 5 BP 469 EP 476 DI 10.1016/S0895-4356(99)00205-X PG 8 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 314UG UT WOS:000087075500004 PM 10812318 ER EF